Sample records for pyloric sphincter dysfunction

  1. Intrinsic neuronal control of the pyloric sphincter of the lamb.

    PubMed

    Mazzuoli, G; Lucherini, M C; Russo, D; Clavenzani, P; Chiocchetti, R

    2008-10-01

    To better understand the local neuronal network of the gastro-duodenal junction in ruminants, we identified the components of the enteric nervous system (ENS) innervating the pyloric sphincter (PS) of the lamb abomasum. The neurons were labelled after injecting the tracer Fast Blue (FB) into the wall of the PS, and the phenotype of the FB-labelled neurons was immunohistochemically investigated using antibodies against nitric oxide synthase (NOS), choline acetyltransferase (ChAT), tachykinin (substance P) and tyrosine hydroxylase (TH). The FB-labelled abomasal myenteric plexus (MP) neurons, observed up to 14cm from the PS, were NOS-immunoreactive (IR) (82+/-12%), ChAT-IR (51+/-29%), SP-IR (61+/-33%), and also TH-IR (2%). The descending nitrergic neurons were also SP-IR (64%) and ChAT-IR (21%); the cholinergic descending neurons were SP-IR (3%). The FB-labelled duodenal neurons were located only in the MP, up to 8cm from the sphincter and were ChAT-IR (79+/-16%), SP-IR (32+/-18%), NOS-IR (from 0 to 2%), and also TH-IR (4+/-3%). The cholinergic ascending neurons were also SP-IR (60%) whereas no ChAT-IR cells were NOS-IR. The findings of this research indicate that the sheep PS is innervated by long-projecting neurons of the abomasal and duodenal ENS. PMID:18571894

  2. What is sphincter of Oddi dysfunction?

    PubMed Central

    Toouli, J

    1989-01-01

    Ever since its description approximately 100 years ago, the sphincter of Oddi has been surrounded by controversy. First, whether it indeed existed, second, whether it had a significant physiological role in man and more recently whether abnormalities in its function give rise to a clinical syndrome. Data from animal and human studies, using sensitive techniques, have helped define the physiological role of the sphincter of Oddi, and more recent studies are determining the factors which control sphincter of Oddi function. These studies support Oddi's original description that the sphincter has a major role in the control of flow of bile and pancreatic juice into the duodenum, and equally importantly helps prevent the reflux of duodenal contents into the biliary and pancreatic ductal systems. The controversy of whether abnormalities in sphincter of Oddi motility result in clinical syndromes has not been totally resolved. Part of the difficulty has been inability to document normal and hence abnormal function of the sphincter. With the emergence of endoscopic biliary manometry as a sensitive and reproducible technique, however, the motility of the human sphincter of Oddi has come under closer scrutiny and allowed definition of possible disorders. We have used the term sphincter of Oddi dysfunction to define manometric abnormalities in patients who present with signs and symptoms consistent with a biliary or pancreatic ductal origin. Based on the manometry, we have subdivided the dysfunction into two groups; a group characterised by a stenotic pattern - that is, raised sphincter basal pressure - and a second group having a dyskinetic pattern - that is, paradoxical response to cholecystokinin injection, rapid contraction frequency, high percentage of retrograde contractions, or short periods of raised basal percentage of retrograde contractions, or short periods of raised basal pressure. It is apparent from the mamometry but also from the clinical data that the patients are a heterogeneous group and thus any therapy would need to be tailored for each patient and abnormality. The most recent therapeutic data suggest that patients with the stenotic pattern on manometry respond to division of the sphincter, however, those patients with the dyskinetic manometric pattern show no significant effect after sphincterotomy. Further prospective trials evaluating therapeutic options are under way and their results are eagerly awaited. Images Fig. 1 PMID:2666281

  3. Contribution of ATP and nitric oxide to NANC inhibitory transmission in rat pyloric sphincter.

    PubMed Central

    Soediono, P; Burnstock, G

    1994-01-01

    1. Changes in isometric tension were recorded from circular muscle strips of rat pyloric sphincter in vitro, in response to electrical field stimulation and exogenously applied muscle relaxants. 2. Concentration-response relationships were studied for relaxation to exogenously applied adenosine 5'-triphosphate (ATP) and two analogues, 2-methylthioATP (2-MeSATP) and alpha,beta-methylene ATP (alpha,beta-MeATP). These drugs evoked concentration-dependent relaxation of rat pyloric sphincter with an order of potency 2-MeSATP > ATP >> alpha,beta-MeATP, indicating the presence of P2y-purinoceptors. The IC50 value of each nucleotide was: 2-MeSATP, 5.0 x 10(-8); ATP, 7.9 x 10(-6) M; alpha,beta-MeATP showed only slight activity at a concentration of 0.1 mM. 3. Frequency-response relationships for relaxations evoked by electrical field stimulation (EFS) were studied in the absence and presence of 10 microM NG-nitro-L-arginine methyl ester (L-NAME, an inhibitor of nitric oxide (NO) synthesis) and 20 microM reactive blue 2 (a P2y-purinoceptor antagonist). It was found that these substances significantly reduced the relaxant response of rat pyloric sphincter to EFS by 40% and 50% respectively. In the presence of both L-NAME and reactive blue 2 the responses were reduced by 75%. 4. Concentration-response relationships were studied for ATP and 2-MeSATP in the presence of L-NAME. It was found that L-NAME did not significantly inhibit the relaxant responses to these drugs. 5. Concentration-response relationships for ATP and noradrenaline were studied in the presence of reactive blue 2 (20 microM); the P2y-antagonist significantly inhibited the relaxant response to ATP, but not that to noradrenaline.(ABSTRACT TRUNCATED AT 250 WORDS) Images Figure 6 PMID:7532079

  4. Gallbladder ejection fraction and its relationship to sphincter of Oddi dysfunction

    Microsoft Academic Search

    Thomas A. Ruffolo; Stuart Sherman; Glen A. Lehman; Robert H. Hawes

    1994-01-01

    Theoretically, relative distal common bile duct obstruction due to sphincter of Oddi dysfunction may be a cause of poor gallbladder evacuation observed on quantitative cholescintigraphy. In this study, the relationship of sphincter of Oddi dysfunction to the gallbladder ejection fraction by quantitative cholescintigraphy was explored. Eighty-one patients with biliary-type pain and otherwise normal evaluations underwent quantitative cholescintigraphy, sphincter of Oddi

  5. Study of the interstitial cells of Cajal in infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    JM Vanderwinden; H Liu; MH De Laet; JJ Vanderhaeghen

    1996-01-01

    BACKGROUND & AIMS: The interstitial cells of Cajal form a network in close association with the smooth muscle of the gut. They are regarded as pacemaker cells and might be involved in motility disorders. Their distribution was studied in a common disorder with a dysfunction of the pyloric sphincter called infantile hypertrophic pyloric stenosis. METHODS: Specimens from 27 infants with

  6. Pseudomonas aeruginosa liver abscesses after diagnostic endoscopic retrograde cholangiography in two patients with sphincter of Oddi dysfunction type 2

    Microsoft Academic Search

    P. Katsinelos; S. Dimiropoulos; D. Katsiba; M. Arvaniti; P. Tsolkas; I. Galanis; B. Papaziogas; V. Limenopoulos; S. Baltajiannis; I. Vasilladis

    Patients with sphincter of Oddi dysfunction have a significantly increased rate of pancreatitis after manometry or sphincterotomy, but septic complications after diagnostic endoscopic retrograde cholangiopancreatography (ERCP) in patients with sphincter of Oddi dysfunction type 2 have not been reported. We describe two patients with sphincter of Oddi dysfunction type 2 in whom Pseudomonas aeruginosa serotype 10 septicemia and multiple small

  7. Sphincter of Oddi Dysfunction: Updates from the Recent Literature.

    PubMed

    Yaghoobi, Mohammad; Romagnuolo, Joseph

    2015-08-01

    Sphincter of Oddi dysfunction (SOD) has long been a controversial topic, starting with whether it even exists, as a sphincterotomy-responsive entity to treat, for either: (1) post-cholecystectomy abdominal pain and/or (2) idiopathic recurrent acute pancreatitis (IRAP). Many of its aspects had required further research to better prove or refute its existence and to provide proper recommendations for physicians to diagnose and treat this condition. Fortunately, there has been major advancement in our knowledge in several areas over the past few years. New studies on challenging the classification, exploring alternative diagnostic methods, and quantifying the role of sphincterotomy in treatment of SOD for post-cholecystectomy pain and for IRAP were recently published, including a randomized trial in each of the two areas. The goal of this paper is to review recent literature on selected important questions and to summarize the results of major trials in this field. PMID:26143628

  8. Pancreatic stenting prevents pancreatitis after biliary sphincterotomy in patients with sphincter of Oddi dysfunction

    Microsoft Academic Search

    Paul R. Tarnasky; Yuko Y. Palesch; John T. Cunningham; Patrick D. Mauldin; Peter B. Cotton; Robert H. Hawes

    1998-01-01

    Background & Aims: Patients with sphincter of Oddi dysfunction are at high risk of developing pancreatitis after endoscopic biliary sphincterotomy. Impaired pancreatic drainage caused by pancreatic sphincter hypertension is the likely explanation for this increased risk. A prospective, randomized controlled trial was conducted to determine if ductal drainage with pancreatic stenting protects against pancreatitis after biliary sphincterotomy in patients with

  9. Vaginal Wall Sling for Anatomical Incontinence and Intrinsic Sphincter Dysfunction: Efficacy and Outcome Analysis

    Microsoft Academic Search

    Shlomo Raz; Lynn Stothers; George P. H. Young; Julie Short; Barbara Marks; Ashok Chopra; Gregory R. Wahle

    1996-01-01

    PurposeA prospective cohort study was done to determine the efficacy and clinical outcome of a new technique for anterior vaginal wall sling construction to treat urinary incontinence due to intrinsic sphincter dysfunction or anatomical incontinence.

  10. Pyloric stenosis

    MedlinePLUS

    Congenital hypertrophic pyloric stenosis; Infantile hypertrophic pyloric stenosis; Gastric outlet obstruction ... intestine through a valve called the pylorus. With pyloric stenosis, the muscles of the pylorus are thickened. This ...

  11. Spinal Cord Stimulation for Intractable Visceral Pain Due to Sphincter of Oddi Dysfunction

    PubMed Central

    Lee, Kang Hun; Lee, Sang Eun; Jung, Jae Wook

    2015-01-01

    Sphincter of Oddi dysfunction (SOD) is a syndrome of chronic biliary pain or recurrent pancreatitis due to the functional obstruction of the pancreaticobiliary flow. We report a case of spinal cord stimulation (SCS) for chronic abdominal pain due to SOD. The patient had a history of cholecystectomy and had suffered from chronic right upper quadrant abdominal pain. The patient had been diagnosed as having SOD. The patient was treated with opioid analgesics and nerve blocks, including a splanchnic nerve block. However, two years later, the pain became intractable. We implanted percutaneous SCS at the T5-7 level for this patient. Visual analog scale (VAS) scores for pain and the amount of opioid intake decreased. The patient was tracked for more than six months without significant complications. From our clinical case, SCS is an effective and alternative treatment option for SOD. Further studies and long-term follow-up are necessary to understand the effectiveness and the limitations of SCS on SOD. PMID:25589948

  12. Strength-Duration Testing of the External Anal Sphincter in Females with Anorectal Dysfunction

    Microsoft Academic Search

    P. M. Mills; G. L. Hosker; E. S. Kiff; A. R. B. Smith

    2002-01-01

    PURPOSE: The strength-duration test has been suggested as a means of assessing external anal sphincter function. This study was designed to investigate this claim by comparing the strength-duration test with established measures of external anal sphincter function. METHODS: Forty-nine females undergoing diagnostic anorectal testing (manometry, rectal sensation, electromyogram, pudendal nerve terminal motor latency, and endoanal ultrasound) also had the strength-duration

  13. Pyloric stenosis

    Microsoft Academic Search

    Bruno Bissonnette; Patrick J. Sullivan

    1991-01-01

    Infantile pyloric stenosis is the most frequently encountered infant gastrointestinal obstruction in most general hospitals.\\u000a Although the primary therapy for pyloric stenosis is surgical, it is essential to realize that pyloric stenosis is a medical\\u000a and not a surgical emergency. Preoperative preparation is the primary factor contributing to the low perioperative complication\\u000a rates and the necessity to recognize fluid and

  14. Hypertrophic pyloric stenosis: Ultrastructural abnormalities of enteric nerves and the interstitial cells of Cajal

    Microsoft Academic Search

    Jacob C. Langer; Irene Berezin; Edwin E. Daniel

    1995-01-01

    Dysfunction of pyloric inhibition has been implicated in the pathophysiology of hypertrophic pyloric stenosis. Normal inhibition likely is mediated by peptideric enteric nerves and also may involve interstitial cells of Cajal (ICC). The authors used electron microscopy to qualitatively assess these structures in infants with pyloric stenosis and in normal controls. Pyloric muscle strips from five infants with hypertrophic pyloric

  15. Sphincter of Oddi Dysfunction

    MedlinePLUS

    ... Advocacy Activities, Legislative & Regulatory Research Leadership Code of Ethics Funding IFFGD Standards For Collaboration Industry Council GI ... x-rays and an endoscope that is passed down to the duodenum, where the bile duct and ...

  16. Pyloric stenosis: congenital or acquired?

    Microsoft Academic Search

    M D Rollins; M D Shields; R J Quinn; M A Wooldridge

    1989-01-01

    Pyloric muscle dimensions were measured in 1400 consecutive newborn infants. Nine of these subsequently developed pyloric stenosis. Their pyloric measurements at birth were all within the normal range. Congenital preformed muscular hypertrophy does not appear to be present in babies who later develop pyloric stenosis.

  17. Infantile hypertrophic pyloric stenosis (IHPS): a study of its pathophysiology utilizing the newborn hph-1 mouse model of the disease.

    PubMed

    Welsh, Christopher; Shifrin, Yulia; Pan, Jingyi; Belik, Jaques

    2014-12-15

    Infantile hypertrophic pyloric stenosis (IHPS) is a common disease of unknown etiology. The tetrahydrobiopterin (BH4)-deficient hyperphenylalaninemia-1 (hph-1) newborn mouse has a similar phenotype to the human condition. For hph-1 and wild-type control animals, pyloric tissue agonist-induced contractile properties, reactive oxygen species (ROS) generation, cGMP, neuronal nitric oxide synthase (nNOS) content, and Rho-associated protein kinase 2 (ROCK-2) expression and activity were evaluated. Primary pyloric smooth muscle cells from wild-type newborn animals were utilized to evaluate the effect of BH4 deficiency. One-week-old hph-1 mice exhibited a fourfold increase (P < 0.01) in the pyloric sphincter muscle contraction magnitude but similar relaxation values when compared with wild-type animals. The pyloric tissue nNOS expression and cGMP content were decreased, whereas the rate of nNOS uncoupling increased (P < 0.01) in 1-wk-old hph-1 mice when compared with wild-type animals. These changes were associated with increased pyloric tissue ROS generation and elevated ROCK-2 expression/activity (P < 0.05). At 1-3 days of age and during adulthood, the gastric emptying rate of the hph-1 mice was not altered, and there were no genotype differences in pyloric tissue ROS generation, nNOS expression, or ROCK-2 activity. BH4 inhibition in pyloric smooth muscle cells resulted in increased ROS generation (P < 0.01) and ROCK-2 activity (P < 0.05). Oxidative stress upregulated ROCK-2 activity in pyloric tissue, but no changes were observed in newborn fundal tissue in vitro. We conclude that ROS-induced upregulation of ROCK-2 expression accounts for the increased pyloric sphincter tone and nNOS downregulation in the newborn hph-1 mice. The role of ROCK-2 activation in the pathogenesis of IHPS warrants further study. PMID:25359537

  18. Fatigability of the External Anal Sphincter in Anal Incontinence

    Microsoft Academic Search

    K. J. Telford; A. S. M. Ali; K. Lymer; G. L. Hosker; E. S. Kiff; J. Hill

    2004-01-01

    INTRODUCTION Anal incontinence commonly results from external anal sphincter dysfunction. The muscle is routinely assessed by anorectal physiology studies. Fatigability is not routinely measured but should be an important factor in the maintenance of continence. The fatigue rate index has been developed to address this. The purpose of this study was to investigate the fatigability of the external anal sphincter

  19. Pyloric stenosis: evolution from pylorospasm?

    Microsoft Academic Search

    John R. Wesley; Michael A. DiPietro; Arnold G. Coran

    1990-01-01

    Over a 10-year period, we have performed pyloromyotomy on 260 infants with hypertrophic pyloric stenosis (HPS), 10 of whom had a history suggestive of pyloric stenosis but initially had neither the physical nor radiological findings to confirm the diagnosis. All 10 demonstrated pylorospasm on upper gastrointestinal series (UGIS), were treated medically without improvement, and subsequently developed classic HPS confirmed by

  20. Prosthetic Sphincter Controls Urination

    NASA Technical Reports Server (NTRS)

    Tenny, John B., Jr

    1986-01-01

    People who lost muscular control of urinary canal through disease or injury aided by prosthetic sphincter. Implanted so it surrounds uretha, sphincter deflated and inflated at will by wearer to start and stop urina tion. Operating pressure adjusted after implantation to accommodate growth or atrophy of urinary canal and prevent tissue damage from excess pressure. Principle adapted to other organs, such as colon, ureter, or ileum.

  1. How should the pyloric submucosal mass coexisting with hypertrophic pyloric stenosis be treated?: a case of pyloric ectopic pancreas with hypertrophic pyloric stenosis.

    PubMed

    Kim, Soo-Hong; Yoo, Tae-Kyung; Kim, Hyun-Young; Jung, Sung-Eun; Park, Kwi-Won

    2014-09-01

    Co-existing pyloric submucosal masses with hypertrophic pyloric stenosis (HPS) are very rare and treating these lesions is always a problem. A 20-day-old boy presented with recurrent episodes of projectile non-bilious vomiting lasting for 5 days. HPS was suspected due to the presenting age and the symptoms. The sonography demonstrated not only circumferential wall thickening of the pylorus, but also a pyloric submucosal mass. At laparotomy, a 0.8 cm sized pyloric submucosal mass was identified along with a hypertrophied pylorus. Pyloric excision was performed due to the possibility of sustaining the symptoms and malignancy. The pathological report of the submucosal mass was ectopic pancreas. Coexisting pyloric lesions can be diagnosed along with HPS, and surgical excision, not just pyloromyotomy, should be considered in these circumstances. To the best of our knowledge, this is the first case report of pyloric ectopic pancreas and HPS to be diagnosed concurrently. PMID:25349837

  2. How Should the Pyloric Submucosal Mass Coexisting with Hypertrophic Pyloric Stenosis Be Treated?: A Case of Pyloric Ectopic Pancreas with Hypertrophic Pyloric Stenosis

    PubMed Central

    Kim, Soo-Hong; Yoo, Tae-Kyung; Jung, Sung-Eun; Park, Kwi-Won

    2014-01-01

    Co-existing pyloric submucosal masses with hypertrophic pyloric stenosis (HPS) are very rare and treating these lesions is always a problem. A 20-day-old boy presented with recurrent episodes of projectile non-bilious vomiting lasting for 5 days. HPS was suspected due to the presenting age and the symptoms. The sonography demonstrated not only circumferential wall thickening of the pylorus, but also a pyloric submucosal mass. At laparotomy, a 0.8 cm sized pyloric submucosal mass was identified along with a hypertrophied pylorus. Pyloric excision was performed due to the possibility of sustaining the symptoms and malignancy. The pathological report of the submucosal mass was ectopic pancreas. Coexisting pyloric lesions can be diagnosed along with HPS, and surgical excision, not just pyloromyotomy, should be considered in these circumstances. To the best of our knowledge, this is the first case report of pyloric ectopic pancreas and HPS to be diagnosed concurrently. PMID:25349837

  3. Obstetric anal sphincter lacerations

    Microsoft Academic Search

    Victoria L Handa; Beate H Danielsen; William M Gilbert

    2001-01-01

    OBJECTIVE:To estimate the frequency of obstetric anal sphincter laceration and to identify characteristics associated with this complication, including modifiable risk factors.METHODS:A population-based, retrospective study of over 2 million vaginal deliveries at California hospitals was performed, using information from birth certificates and discharge summaries for 1992 through 1997. We excluded preterm births, stillbirths, breech deliveries, and multiple gestations. The main outcome

  4. The changing presentation of pyloric stenosis

    Microsoft Academic Search

    Konstantinos Papadakis; E. Alexandria Chen; François I Luks; Marc S Lessin; Conrad W Wesselhoeft; Frank G Deluca

    1999-01-01

    Metabolic abnormalities described in pyloric stenosis are now rare, probably because of prompter recognition of the disease. This report reviews the trend in presentation over three decades. All infants treated for pyloric stenosis during three mid-decade target periods were reviewed. Comparison between the 1975 group and the 1985 group and between the 1995 group and previous decades were designed to

  5. Prosthetic urinary sphincter

    NASA Technical Reports Server (NTRS)

    Helms, C. R.; Smyly, H. M. (inventors)

    1981-01-01

    A pump/valve unit for controlling the inflation and deflation of a urethral collar in a prosthetic urinary sphincter device is described. A compressible bulb pump defining a reservoir was integrated with a valve unit for implantation. The valve unit includes a movable valve member operable by depression of a flexible portion of the valve unit housing for controlling fluid flow between the reservoir and collar; and a pressure sensing means which operates the valve member to relieve an excess pressure in the collar should too much pressure be applied by the patient.

  6. Pyloric muscle in asymptomatic infants: sonographic evaluation and discrimination from idiopathic hypertrophic pyloric stenosis

    Microsoft Academic Search

    Wiltrud K. Rohrschneider; Henry Mittnacht; Kassa Darge; Jochen Tröger

    1998-01-01

    Objective. To compare the morphological and functional US appearance of the pylorus in healthy infants with those suffering from idiopathic\\u000a hypertrophic pyloric stenosis (IHPS) in order to determine the pathological limits and to find out the most discriminating\\u000a morphometric parameter. Materials and methods. The pylorus of 84 asymptomatic infants was prospectively evaluated with respect to morphology (pyloric length, pyloric diameter,

  7. Clinical diagnosis of pyloric stenosis: a declining art

    Microsoft Academic Search

    J Macdessi; R K Oates

    1993-01-01

    OBJECTIVE--To assess whether diagnostic imaging of pyloric stenosis has made a difference in rapidity of diagnosis, duration of pre-operative hydration, and length of stay in hospital. DESIGN--Chart review of infants with confirmed diagnosis of pyloric stenosis. SETTING--Paediatric teaching hospital. SUBJECTS--215 infants with a confirmed diagnosis of pyloric stenosis seen during 1974-7 and 187 infants with pyloric stenosis seen during 1988-91.

  8. Effect of Ovariectomy on External Urethral Sphincter Activity in Anesthetized Female Rats

    PubMed Central

    Cheng, Chen-Li; de Groat, William C.

    2011-01-01

    Purpose The postmenopausal hypoestrogen condition is associated with various lower urinary tract dysfunctions, including frequency, urgency, stress urinary incontinence and recurrent urinary infection. We determined whether hypoestrogen induced lower urinary tract dysfunction after ovariectomy is also associated with an alteration in external urethral sphincter activity. Materials and Methods Bilateral ovariectomy was performed in female Sprague-Dawley® rats and sham operated rats served as controls. Transvesical cystometry and external urethral sphincter electromyogram activity were monitored 4, 6 and 12 weeks after sham operation or bilateral ovariectomy and at 6 weeks in bilaterally ovariectomized rats treated with estrogen. Results The micturition reflex was elicited in sham operated and bilaterally ovariectomized, urethane anesthetized animals. Post-void residual urine increased and voiding efficiency decreased in rats with 4 to 12 weeks of bilateral ovariectomy. The silent period of external urethral sphincter electromyogram activity was shortened significantly and progressively at increased times after bilateral ovariectomy. These effects were prevented by estradiol treatment. Conclusions As evidenced by shortening of the external urethral sphincter electromyogram silent period in ovariectomized rats, the disruption of coordination between the external urethral sphincter and the detrusor muscle could decrease urine outflow and in turn voiding efficiency. Estrogen replacement reverses these changes, suggesting that the central pathways responsible for detrusor-sphincter coordination are modulated by gonadal hormones. PMID:21600603

  9. Infantile hypertrophic pyloric stenosis: myopathic type

    Microsoft Academic Search

    R. Dieler; J. M. Schröder; H. Skopnik; G. Steinau

    1990-01-01

    Smooth muscle cell biopsies obtained at pyloromyotomy from 37 children with infantile hypertrophic pyloric stenosis (IHPS) were studied by light and electron microscopy and compared with 6 autopsy control cases without any clinical evidence of this disorder. In cases with IHPS an apparently irregular increase in the number of smooth muscle cells by mitosis was accompanied by an increase of

  10. Postcholecystectomy Pain Syndrome: Pathophysiology of Abdominal Pain in Sphincter of Oddi Type III

    Microsoft Academic Search

    STEVEN G. DESAUTELS; ADAM SLIVKA; WILLIAM R. HUTSON; ANDREW CHUN; CARLOS MITRANI; CARLO DILORENZO; ARNOLD WALD

    1999-01-01

    Background & Aims: Persistent abdominal pain occurs in many patients after cholecystectomy, some of whom are described as having sphincter of Oddi dysfunction (SOD). Pain in SOD type III is thought to be of biliary origin with little objective data, and treatment is often unsatisfactory. Chronic abdominal pain without a bio- logical disease marker is similar to irritable bowel syndrome,

  11. The various types of neurogenic bladder dysfunction: an update of current therapeutic concepts

    Microsoft Academic Search

    H Madersbacher

    1990-01-01

    Increased experience with treatment strategies developed during the last 10 years in the field of neurourology justifies an update of current therapeutic concepts. Based on a rather simple, but clinically useful, classification of detrusor-sphincter dysfunction the therapeutic concepts now available for four prototypes of detrusor-sphincter dysfunction are discussed.(1)For the combination of a hyperreflexive detrusor with a hyperreflexive (spastic) sphincter, characteristic

  12. The cardiac sphincter in the cat

    PubMed Central

    Clark, C. G.; Vane, J. R.

    1961-01-01

    A study of the function of the lower end of the oesophagus in the cat confirms that it behaves as a true physiological sphincter, even though histological evidence for such a structure is absent. Sphincteric action is a function of the circular muscle fibres in the lowest 2 cm. of the oesophagus. Reflex changes in tone of the sphincter are mediated through the autonomic nervous system. The effects of possible neurohumoral transmitters, nerve stimulation, and antagonists have been studied. PMID:13879670

  13. Primary cricopharyngeal dysfunction: Treatment with balloon catheter dilatation

    Microsoft Academic Search

    Jeno Solt; Judit Bajor; Mariann Moizs; Erzsébet Grexa; Péter Ö. Horváth

    2001-01-01

    Background: Primary cricopharyngeal dysfunction (PCD) is a rare, idiopathic, functional disorder of the upper esophageal sphincter, characterized by dysphagia, frequent aspiration, and functional narrowing at the level of the upper esophageal sphincter. Methods: Five of 29 patients with oropharyngeal dysphagia were found to have PCD. Patients presented with severe dysphagia and predisposition to aspiration. Radiography demonstrated narrowing at the level

  14. Ultrasound compared with clinical examination in infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    P Godbole; A Sprigg; J A Dickson; P C Lin

    1996-01-01

    OBJECTIVES: To assess the accuracy of clinical examination as compared with ultrasound imaging in the diagnosis of infantile hypertrophic pyloric stenosis. Duration of hospital stay, time between admission and surgery, and financial implications were also considered. DESIGN: A prospective study of patients referred to the surgical team with a possible diagnosis of pyloric stenosis from May 1993 to January 1995.

  15. Muscle Thickness in Hypertrophic Pyloric Stenosis: Sonographic Determination

    Microsoft Academic Search

    Joel D. Blumhagen; H. George; S. Noble

    Abdominal sonography was performed in 169 infants with vomiting. The hypertro- phied circular muscle of the pylorus and distal antrum could be seen as a thick, hypoechoic cylinder in all cases of hypertrophic pyloric stenosis. The thickness of each wall of this cylinder was 4 mm or more in 86 of 93 patients subsequently shown to have hypertrophic pyloric stenosis

  16. Recent results of treatment of infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    B Zeidan; J Wyatt; A Mackersie; R J Brereton

    1988-01-01

    During the five year period December 1980 to November 1985, 106 infants with hypertrophic pyloric stenosis were treated. There were no operative deaths, but two late deaths occurred from associated abnormalities. The combination of preoperative rehydration, skilled anaesthesia, and the use of the Fredet-Ramstedt operation (pyloromyotomy) have virtually eliminated mortality from uncomplicated infantile hypertrophic pyloric stenosis. The most common complications

  17. Infantile hypertrophic pyloric stenosis in Belfast, 1957-1969

    Microsoft Academic Search

    J A Dodge

    1975-01-01

    Infants with hypertrophic pyloric stenosis born in Belfast during the 13 years 1957-1969 have been reviewed. Their distribution shows a bias towards higher social classes, breast feeding, and primogeniture. Obstetric factors and parental ages seem to be of no importance. More affected infants were born during winter months than would be expected. The overall incidence of infantile pyloric stenosis in

  18. Advances in infantile hypertrophic pyloric stenosis.

    PubMed

    Peters, Babette; Oomen, Mathijs W N; Bakx, Roel; Benninga, Marc A

    2014-07-01

    Infantile hypertrophic pyloric stenosis (IHPS) is a common condition in infancy, characterized by an acquired narrowing of the pylorus, which requires surgery. These infants usually present with projectile, nonbilious vomiting, with a palpable 'olive' in the abdomen and sometimes a 'peristaltic wave' after being fed with formula or breast milk. Although IHPS is a common disorder, its etiology is largely unknown. Surgical intervention is the standard treatment, preoperative preparation, however is essential to optimal outcome. In this review, the latest advances in IHPS regarding epidemiology, etiology, diagnostics and treatment will be discussed. PMID:24716658

  19. Results with sphincter pharyngoplasty and pharyngeal flap

    Microsoft Academic Search

    Lianne M. de Serres; Frederic W.-B. Deleyiannis; Linda E. Eblen; Joseph S. Gruss; Mark A. Richardson; Kathleen C. Y. Sie

    1999-01-01

    Objective: To evaluate speech outcomes and complications of sphincter pharyngoplasty and pharyngeal flap performed for management of velopharyngeal insufficiency (VPI). Design: Case series. Setting: Tertiary care children’s hospital. Patients: All patients who underwent pharyngeal flap or sphincter pharyngoplasty from 1990 to 1995. Methods: Perceptual speech analysis was used to assess severity of VPI, presence of nasal air emissions and quality

  20. The treatment of sphincter strictures.

    PubMed

    Mundy, A R

    1989-12-01

    A group of 25 patients with strictures of the membranous urethra following transurethral resection of the prostate (TURP) were investigated and treated initially by careful urethral dilatation. This controlled the stricture in 14 patients, 6 of whom continued with occasional dilatation or self-catheterisation to maintain control; 8 required an artificial urinary sphincter (AUS) and 2 required a "clam" ileocystoplasty for detrusor instability. Eleven had persistent or recurrent strictures requiring urethroplasty. Nine underwent bulbo-prostatic anastomotic urethroplasty, 4 with simultaneous bladder neck reconstruction and 5 with subsequent implantation of an AUS; 2 had a preputial patch urethroplasty with subsequent implantation of an AUS. Four of the 9 patients with a urethroplasty and an AUS are satisfactory, 1 developed a recurrent stricture and 2 developed erosions. Two of those with a bulbo-prostatic anastomosis and bladder neck reconstruction are satisfactory and 2 are incontinent. These results were compared with those of 18 other patients who underwent bladder neck reconstruction and 12 who had a urethroplasty in conjunction with an AUS for reasons other than a post-TURP sphincter stricture. The success rate of bladder neck reconstruction was 55% and the success rate of urethroplasty in conjunction with an AUS was 83%, but the main complication of AUS implantation, erosion, was a more serious problem than failure of bladder neck reconstruction. However, the much higher success rate makes AUS implantation a more satisfactory procedure. Surgery should be avoided if at all possible and reliance placed on urethral dilatation. PMID:2627637

  1. Infantile hypertrophic pyloric stenosis: does size really matter?

    PubMed

    Hsu, Peter; Klimek, Jan; Nanan, Ralph

    2014-10-01

    Pyloric stenosis is a common infantile disorder typically occurring between 2 weeks and 8 weeks of age. Presentation outside this range and in premature infants is uncommon and often atypical. We present three cases, a pair of premature twins and a 5.5-month-old infant with pyloric stenosis. We highlight that despite their difference in size and weight, ultrasound examination remains a reliable diagnostic tool. However, pyloric measurements should be interpreted in combination with the other dynamic features on ultrasound. PMID:20598068

  2. Surgical Reconstruction of the Urinary Sphincter after Traumatic Longitudinal Disruption

    PubMed Central

    Rehder, Peter; Schillfahrt, Florian; Skradski, Viktor

    2014-01-01

    The question is whether the urethral sphincter may be reconstructed after longitudinal injury similar to anal sphincter injuries. Analogue to obstetric, anal sphincter repair, an approximation repair of the sphincter may be feasible. An overlap repair is possible in anal sphincter repair, but because of the little tissue available in the urethral sphincter this is not an option. We describe three cases of urethral sphincter injury of different aetiologies. All resulted in a total longitudinal disruption of the muscular components of the urethral sphincter complex. After making the diagnosis of urethral sphincter injury, a primary approximation repair was done. Follow-up of at least two and up to three years is promising with one male patient being completely continent and the two female patients needing one safety pad per day. Longitudinal disruption of the muscular elements of the sphincteric urethra may be primarily reconstructed with good success using an approximation technique with simple interrupted sutures. PMID:25258694

  3. The improved ultrasound diagnosis of hypertrophic pyloric stenosis

    Microsoft Academic Search

    R. J. Stunden; G. W. LeQuesne; K. E. T. Little

    1986-01-01

    A prospective study of ultrasound in the diagnosis of idiopathic hypertrophic pyloric stenosis (IHPS) in 200 consecutive infants\\u000a with persistent vomiting is reported. The criteria evaluated include measurements of the pyloric diameter, muscle thickness\\u000a and canal length, and observing the function of the pylorus and gastric peristalsis in real-time. Using these ultrasonic criteria,\\u000a the infants studied were assessed as 112

  4. Prenatal prescription of macrolide antibiotics and infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    William O Cooper; Wayne A Ray; Marie R Griffin

    2002-01-01

    Objective:To assess the association between prenatal antibiotics, including erythromycin, and infantile hypertrophic pyloric stenosis in a large cohort of infants.Methods:This was a retrospective cohort study of births to women enrolled in Tennessee Medicaid\\/TennCare, 1985–1997. Prescriptions for erythromycin, nonerythromycin macrolides, and other antibiotics were identified from pharmacy files linked with birth certificate files. The primary study outcome was development of pyloric

  5. Simultaneous penile prosthesis and male sling/artificial urinary sphincter

    PubMed Central

    Lee, Dominic; Romero, Claudio; Alba, Frances; Westney, O Lenaine; Wang, Run

    2013-01-01

    Erectile dysfunction (ED) and stress urinary incontinence (SUI) from urethral sphincteric deficiency is not an uncommon problem. The commonest etiology is intervention for localized prostate cancer and/or radical cystoprostatectomy for muscle invasive bladder cancer. Despite advances in surgical technology with robotic assisted laparoscopic prostatectomy and nerve sparing techniques, the rates of ED and SUI remain relatively unchanged. They both impact greatly on quality of life domains and have been associated with poor performance outcomes. Both the artificial urinary sphincter and penile prosthesis are gold standard treatments with proven efficacy, satisfaction and durability for end-stage SUI and ED respectively. Simultaneous prosthesis implantation for concurrent conditions has been well described, mostly in small retrospective series. The uptake of combination surgery has been slow due in part to technical demands of the surgery and to an extent, a heightened anxiety over potential complications. This paper aims to discuss the technical aspect of concurrent surgery for both disease entity and the current published outcomes of the various surgical techniques with this approach. PMID:23202702

  6. Das Faserkaliber in den Mm. transversus perinei und Sphincter urethrae

    Microsoft Academic Search

    H. Hayek

    1960-01-01

    Der M. sphincter urethrae externus oder Rhabdosphincter des Mannes besteht im Gegensatz zum M. transversus perinei aus dünnen, quergestreiften Muskelfasern von nur 1\\/3–1\\/4 der Dicke der Fasern des letzteren. Die Fasern des Sphincter sind von reichlich Bindegewebe umhüllt und fest zusammengehalten. Der Sphincter erscheint von etwas hellerer Farbe als der Transversus und läßt sich präparatorisch leicht trennen. Die dünnen quergestreiften

  7. Monitoring of upper oesophageal sphincter pressure in children

    Microsoft Academic Search

    G P Davidson; J Dent; J Willing

    1991-01-01

    In children technical limitations of upper oesophageal sphincter manometry have restricted investigation to the pull through technique under sedation. In this study we have used an adapted sleeve manometric technique for upper oesophageal sphincter monitoring in unsedated children and determined the influence of the state of arousal on upper oesophageal sphincter pressure. Twenty six children aged 3 to 42 months

  8. Overlapping Repair in Patients with Anal Sphincter Injury

    Microsoft Academic Search

    Sezai Demirbas; Vedat Atay; Ilker Sucullu; A. Ilker Filiz

    2008-01-01

    Objective: The aim of this study was to demonstrate the improvement of anal canal function after overlap sphincter repair and confirm that this treatment option is superior in patients with nonobstetric sphincter damage. Subjects and Methods: From 1998 to 2003, 44 women who underwent overlapping sphincter repair were enrolled in this study. The women were allocated to one of two

  9. Antenatally diagnosed congenital pyloric duplication associated with intraluminal pyloric cyst--rare entity case report and review of the literature.

    PubMed

    M?rginean, Cristina Oana; M?rginean, Claudiu; Horváth, Em?ke; Gozar, Liliana; Gozar, Horea Gheorghe

    2014-01-01

    Duplication of the digestive tract is a very rare malformation in children whereas the congenital pyloric duplication is extremely rare, few cases being described in the literature. We present the case of a male infant, aged seven days, who was diagnosed at 17 weeks of gestation with a cystic mass in the abdomen and who presented vomiting in the sixth day of life. Ultrasound and CT diagnosed a pyloric duplication cyst. The malformation was visualized intraoperatively and removed successfully without incidents. The infant's postoperative evolution was excellent, with an upward weight curve without a dumping syndrome. Finally, we present a review of the published cases of congenital pyloric duplications in the world, this one being the fifth one reported of the prenatally diagnosed cases. PMID:25329132

  10. Pancreatitis after sphincter of Oddi manometry.

    PubMed Central

    Rolny, P; Anderberg, B; Ihse, I; Lindström, E; Olaison, G; Arvill, A

    1990-01-01

    The nature, frequency, severity, and possible causes of complications after 207 sphincter of Oddi manometry measurements were studied in 146 patients. Acute pancreatitis was diagnosed in 6% (12 of 207) of the investigations and in 8% (12 of 146) of the patients examined. The pancreatitis was mild in all patients. After cannulation of the pancreatic duct, acute pancreatitis occurred in 10 of 95 (11%) patients compared with one of 93 (1%) when the manometry catheter entered the bile duct only (p less than 0.02). Seven (58%) of the patients who developed acute pancreatitis, however, were found to be suffering from chronic pancreatitis. Some 26% of all sphincter of Oddi manometry measurements on patients with this diagnosis were complicated by an acute attack of pancreatitis compared with 3% (p less than 0.001) in patients without signs of chronic pancreatitis. In all patients the pancreatitis developed within three hours of manometry. We conclude that pancreatitis may occasionally follow sphincter of Oddi manometry measurement, even in patients without pancreaticobiliary disease, and that underlying chronic pancreatitis constitutes a definite risk. Sphincter of Oddi manometry measurement in control subjects should therefore be performed only in centres where the safety of the procedure has been established, and the presence of chronic pancreatitis should be excluded beforehand. Cannulation of the pancreatic duct should be avoided. Manometry can be safely performed, however, as an outpatient procedure. PMID:2370018

  11. Obstetric events leading to anal sphincter damage

    Microsoft Academic Search

    Valerie Donnelly; Michelle Fynes; Deirdre Campbell; Howard Johnson; P. Ronan O’Connell; Colm O’Herlihy

    1998-01-01

    Objective: To identify the obstetric factors relating to anal sphincter injury at first vaginal delivery by prospective cohort study of primiparous women.Methods: We compared the results of a bowel function questionnaire and anal vector manometry before and 6 weeks after delivery in 184 primiparous women. Postpartum, pudendal nerve conduction latency was measured in all women, and anal endosonography was performed

  12. Disturbed anal sphincter function following vaginal delivery.

    PubMed Central

    Wynne, J M; Myles, J L; Jones, I; Sapsford, R; Young, R E; Hattam, A; Cantamessa, S E

    1996-01-01

    BACKGROUND: Recently interest in idiopathic (neurogenic) faecal incontinence has swung from denervation of the external anal sphincter to the internal sphincter. AIMS: To evaluate the effects of vaginal delivery on the internal sphincter. SUBJECTS: 1372 mothers were studied antenatally and 1202 were accepted into the study. METHODS: Sphincter pressures were measured antenatally, in the early postnatal period, and six to 10 weeks later in selected patients. RESULTS: 755 of 1202 subjects assessed antenatally were primiparous women and 447 multiparous women. Some 320 previous spontaneous vaginal deliveries (SVD) (mean 59 mm Hg) and 67 previous forceps deliveries (mean 58 mm Hg) had lower resting pressures than 755 primiparous women (mean 66 mm Hg) (p < 0.01). A total of 493 subjects were reassessed postnatally. There were 372 SVDs, 47 vacuum extractions, 20 forceps, and 54 caesarean deliveries. All vaginal deliveries but not caesarean sections dropped their resting anal pressures from antenatal values (p < 0.001). Some 227 first SVDs had a much greater fall than 145 subsequent SVDs. In 162 subjects who had undergone their first vaginal delivery and who were followed up there was some recovery but the resting pressures were still lowered at six to 10 weeks post partum. CONCLUSIONS: The first vaginal delivery causes a permanent lowering of resting anal pressures. The possible reasons for this are discussed. PMID:8881822

  13. Myenteric plexus neuropathy in infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    R. Dieler; J. M. Schröder

    1989-01-01

    The myenteric plexus and intramuscular nerve bundles in the circular muscle layer of the pylorus from 37 children with infantile hypertrophic pyloric stenosis (IHPS) obtained at pyloromyotomy were studied by light and electron microscopy and compared to six control cases without clinical evidence of IHPS. In certain IHPS cases degenerative alterations of the axons predominated. The axonal changes consisted of

  14. Vomiting after pyloromyotomy for infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    L Spitz

    1979-01-01

    An analysis of the factors which may predispose towards postoperative vomiting after pyloromyotomy for hypertrophic pyloric stenosis was carried out in 72 infants at this hospital. 26 (36%) infants experienced moderate to severe postoperative vomiting of sufficient intensity to cause the postoperative feeding regimen to be modified or interrupted. Only two parameters were found to be of statistical significance. These

  15. Genetic analyses of pyloric stenosis suggesting a specific maternal effect

    Microsoft Academic Search

    K K Kidd; M A Spence

    1976-01-01

    Data on pyloric stenosis are analysed by multiple threshold methods that incorporate the sex effect. The polygenic model of inheritance is rejected; the single major locus model can only account for 37% of the cases having a genetic aetiology, requiring an environmental effect to account for the remainder of the cases. A maternal-fetal interaction for gastrin production and sensitivity is

  16. The pathology of infantile hypertrophic pyloric stenosis after healing

    Microsoft Academic Search

    Jean-Marie Vanderwinden; Hao Liu; Roberte Menu; Jean-Louis Conreur; Marc-Henri De Laet; Jean-Jacques Vanderhaeghen

    1996-01-01

    Introduction: Infantile hypertrophic pyloric stenosis (IHPS) is a common surgical affection of unknown etiology. The muscular hypertrophy is known to resolve within a few months after pyloromyotomy (PM). The pathology of IHPS has been studied extensively at the time of PM, but the fate of the pylorus after healing remains unknown. Materials and Methods: We had the rare opportunity to

  17. Congenital pyloric stenosis: a modified umbilical incision for pyloromyotomy

    Microsoft Academic Search

    R. Besson; R. Weir; C. Salakos; P. Debeugny

    1997-01-01

    Thirty-two patients underwent a pyloromyotomy via an umbilical incision; in 11 a modified umbilical approach was used to facilitate delivery of the pyloric mass. Incisions are made in the skin fold of the upper half of the umbilicus and at the midline, joining the two at the top. The skin incision is closed by upper umbilical translocation with a very

  18. Pyloromyotomy versus atropine sulfate for infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    Atsuyuki Yamataka; Kazuko Tsukada; Yuko Yokoyama-Laws; Mitsunori Murata; Makiko Osawa; Takao Fujimoto; Takeshi Miyano

    2000-01-01

    Purpose: Atropine sulfate (atropine) and pyloromyotomy were compared for managing infantile hypertrophic pyloric stenosis (IHPS).Methods: From 1996 to 1998, cases of IHPS treated surgically (pyloromyotomy; n = 20) or medically (atropine; n = 14) at separate institutions were compared retrospectively with regard to status on presentation, physical symptoms and signs, progress, and costs. Atropine was given orally, then intravenously if

  19. Pyloric stenosis in the Oxford Record Linkage Study area

    Microsoft Academic Search

    P Adelstein; J Fedrick

    1976-01-01

    The files of the Oxford Record Linkage Study were employed to identify 220 infants presenting with infantile hypertrophic pyloric stenosis (IHPS) in the 6-year period 1966 to 1971. Information on these infants was obtained from birth certificates and maternity notes. The overall incidence was 2.5 per 1000 livebirths. There was a distinct seasonal variation, with highest incidence to infants born

  20. A novel artificial anal sphincter system in an in vitro and in vivo experiment.

    PubMed

    Ke, Lei; Yan, Guo-Zheng; Liu, Hua; Jiang, Ping-Ping; Liu, Zhi-Qiang; Wang, Yong-Bing; Ding, Zai-Xian

    2014-03-01

    This paper presents some of the latest progress in the development of a novel artificial anal sphincter system (AASS) to treat severe fecal incontinence. We have redesigned and integrated an intelligent, remote-controlled artificial anal sphincter based on biological signal feedback mechanisms. The device consists of an external telemetry unit, an internal artificial anal sphincter (IAAS), and a transcutaneous energy transfer system (TETS). The mechanical medical micropump of the IAAS can realize bidirectional flow with a maximum flow rate of 8.5 ml/min and can build backpressure up to 170 kPa. The design of the prosthesis reduces occlusion pressure and allows for low inflation volumes (9 mL-10.5 mL); operating pressures between 4.05 kPa and 7.16 kPa indicate that the risk of ischemic injury to the bowel is minimal. Furthermore, the rechargeable battery based on TETS puts the operation time at an estimated 2 days. The performance characteristics of the AASS and its efficiency in achieving continence and sensing the stool inside the anorectum were evaluated in vitro and in vivo in a pig model. Experimental results confirm that the system can maintain continence and build the sense of defecation successfully. Moreover, this innovation can be integrated into not only severe fecal incontinence, erectile dysfunction, and therapy-resistant reflux disease, but also morbid adiposity therapeutic AASS applications. PMID:24744170

  1. Sphincter repair for fecal incontinence after obstetrical or iatrogenic injury

    Microsoft Academic Search

    Michael E. Pezim; Robert J. Spencer; C. Robert Stanhope; Robert W. Beart; Roger L. Ready; Duane M. Ilstrup

    1987-01-01

    Forty patients with fecal incontinence underwent sphincter repair between 1975 and 1984. Divided sphincter musculature resulted\\u000a from obstetrical injury in 23 and previous anorectal surgery in 17. Eighteen had undergone a previous attempt at repair. Fifteen\\u000a patients experienced seepage of stool and 25 had gross incontinence. In nine patients, reconstruction of the external sphincter\\u000a was by overlap of the muscle

  2. Expression of the crustacean pyloric pattern generator in the intact animal

    Microsoft Academic Search

    Elizabeth Rezer; Maurice Moulins

    1983-01-01

    1.InJasus lalandii the activity of the central pattern generator of the pyloric motor output (the pyloric CPG) has been studied in intact free animals by electromyographic recording of the pyloric muscles (Fig. 2).2.Two patterns of activity (pattern 1 and pattern 2) can be observed. Each pattern corresponds to a specific behavioural situation: pattern 1 is only observed in unfed lobsters

  3. Pyloric trichobezoar in a Canadian lynx (Lynx canadensis).

    PubMed

    Kottwitz, Jack; Munsterman, Amelia S

    2013-12-01

    An adult female Canadian lynx (Lynx canadensis) was presented with a 3-wk history of anorexia and lethargy. Initial examination and diagnostics did not provide a diagnosis. The lynx continued to demonstrate vague clinical signs, including anorexia and an abnormal gait. During follow-up immobilizations 2 wk later, a barium gastrointestinal study revealed a pyloric obstruction. Abdominal exploratory surgery was elected, and a gastrotomy and an enterotomy of the proximal duodenum were performed to remove the pyloric obstruction. The obstruction was determined to be a trichobezoar. Fleas, a likely cause of hair ingestion through grooming, were noted during surgical preparation. The lynx made a full recovery from surgery. Reoccurrence of the trichobezoar was prevented after surgery with the use of monthly flea control and three times a week hairball laxative. PMID:24450081

  4. Pathogenesis of infantile hypertrophic pyloric stenosis: recent progress

    Microsoft Academic Search

    K. Ohshiro; P. Puri

    1998-01-01

    Although infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring surgery in the first few months\\u000a of life, its pathogenesis is not fully understood. Reviews of the recent progress in the pathogenesis of IHPS show: (1) there\\u000a is increasing evidence to suggest that smooth-muscle cells in IHPS are not properly innervated; (2) because non-adrenergic,\\u000a non-cholinergic nerves are mediators

  5. Early experience with laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    A Najmaldin; H. L Tan

    1995-01-01

    The authors report on 37 infants with infantile hypertrophic pyloric stenosis who underwent successful laparoscopic pyloromyotomy. The average age was 6 weeks and average weight was 4.5 kg. Three 4-mm ports were used in each procedure. The average operating time was 29 minutes (range, 7 to 60 minutes). Feeding was begun an average of 5.2 hours (range, 3 to 12

  6. Bowel Dysfunction

    MedlinePLUS

    ... My Bridge 4 Life Clinical Trials Guides Newsletters Nutrition & Wellness PCF Spotlight Glossary African American Men Living with Prostate Cancer Bowel Dysfunction Side Effects Urinary Dysfunction Bowel Dysfunction ...

  7. Urinary Dysfunction

    MedlinePLUS

    ... My Bridge 4 Life Clinical Trials Guides Newsletters Nutrition & Wellness PCF Spotlight Glossary African American Men Living with Prostate Cancer Urinary Dysfunction Side Effects Urinary Dysfunction Bowel Dysfunction ...

  8. Effects of pinaverium bromide on Oddi's sphincter.

    PubMed

    DiSomma, C; Reboa, G; Patrone, M G; Mortola, G P; Sala, G; Ciampini, M

    1986-01-01

    Twelve to 15 days after cholecystectomy, endocholedochal pressure was measured in ten patients before and one hour after oral administration of 15 mg of pinaverium bromide (six patients) or placebo. The mean endocholedochal pressure was 7.1 +/- 0.25 mmHg before and 3.1 +/- 0.2 mmHg after pinaverium (P less than 0.01), and 7.0 +/- 0.2 and 6.8 +/- 1.2 mmHg in the placebo-treated patients. The results suggest that pinaverium bromide has a specific effect on the common bile duct and probably on Oddi's sphincter. PMID:3815457

  9. Sphincters of the pulmonary veins in man, and their significance

    Microsoft Academic Search

    L. L. Kapuller; M. Lo Shik

    1961-01-01

    Pressure curves in the pulmonary vein and in the left auricle were recorded in patients with stenosis of the left atrioventricular valve before and after mitral valvotomy. The curves showed that the sphincters of the pulmonary veins may fail when the mean pressure in the left auricle exceeds 20 mm Hg. Normally, by blocking the reverse flow, the sphincters protect

  10. The innervation of the pyloric region of the crab, Cancer borealis : Homologous muscles in decapod species are differently innervated

    Microsoft Academic Search

    Scott L. Hooper; Michael B. O'Neil; Robert Wagner; John Ewer; Jorge Golowasch; Eve Marder

    1986-01-01

    The muscles of the pyloric region of the stomach of the crab,Cancer borealis, are innervated by motorneurons found in the stomatogastric ganglion (STG). Electrophysiological recording and stimulating techniques were used to study the detailed pattern of innervation of the pyloric region muscles. Although there are two Pyloric Dilator (PD) motorneurons in lobsters, previous work reported four PD motorneurons in the

  11. Who should treat pyloric stenosis: The general or specialist pediatric surgeon?

    Microsoft Academic Search

    A. J. L Brain; D. S Roberts

    1996-01-01

    Recent reports suggest that children under 3 years of age are best operated on by a specialist pediatric surgeon. In the United Kingdom, hypertrophic pyloric stenosis traditionally has been treated by adult general surgeons. Should this change? In 1991, a retrospective review of 10 years' experience with pyloric stenosis, managed by general surgeons in a large district general hospital, was

  12. Altered messenger RNA expression of the neuronal nitric oxide synthase gene in infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    T. Kusafuka; P. Puri

    1997-01-01

    Nitric oxide (NO) has been described as a mediator of smooth muscle relaxation in the mammalian gastrointestinal tract. The enzyme neuronal nitric oxide synthase (NOS) catalyzes the formation of NO. We examined the expression of the neuronal NOS gene at the messenger RNA (mRNA) level in pyloric smooth-muscle biopsy specimens from six patients with infantile hypertrophic pyloric stenosis (IHPS) using

  13. Hypertrophic pyloric stenosis in twins; genetic or environmental factors.

    PubMed

    Gezer, H Ö; Oguzkurt, P; Temiz, A; Hicsonmez, A

    2015-04-01

    The etiology of infantile hypertrophic pyloric stenosis (IHPS) remains obscure. Over 120?years after the condition has become a clinical entity the debate whether the cause of IHPS is genetic, environmental or both, has not yet reached a final conclusion. Herein, we present a pair of monozygotic male twins with IHPS together with a review of the literature. We aimed to support genetic pre-disposition in the epidemiology of IHPS, adding a twin data to the literature and to review the associated articles about the pathogenesis and inheritance patterns. PMID:24724922

  14. [Anal sphincter injury caused by falling off a trampoline].

    PubMed

    Pakarinen, Mikko

    2013-01-01

    A girl of preschool age fell off a trampoline in a sitting position onto an iron bar sticking up from the ground. In addition to a laceration of the terminal portion of the rectum, she was found to have a severe sphincter injury. The sphincters were repaired by a surgeon the next morning. After one month from the surgery the anal canal pressure was found to be symmetrical with good contractile force of the sphincters. No abnormalities were found in a contrast study or in rectoscopy. The protective stoma was closed after three months from the injury and fecal continence was normal after one and a half years. PMID:23901741

  15. Hypertrophic pyloric stenosis following repair of esophageal atresia and tracheo-esophageal fistula.

    PubMed

    Seguier-Lipszyc, Emmanuelle; Klin, Baruch

    2014-01-01

    Two cases of hypertrophic pyloric stenosis (HPS) developed after a few weeks of repair of an esophageal atresia and tracheo-esophageal fistula (EA and TEF). Both cases were dealt successfully with laparoscopic pyloromyotomy. PMID:26023501

  16. Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: a prospective, randomized controlled trial

    Microsoft Academic Search

    Marc-David Leclair; Valérie Plattner; Eric Mirallie; Corinne Lejus; Jean-Michel Nguyen; Guillaume Podevin; Yves Heloury

    2007-01-01

    BackgroundSeveral authors have reported on laparoscopic pyloromyotomy (LP) since the technique was originally described in 1990, but its benefits remain unproven. We performed a randomized controlled trial comparing LP to open circumumbilical pyloromyotomy (OP) for hypertrophic pyloric stenosis.

  17. Pyloric balloon dilation for delayed gastric emptying in children.

    PubMed

    Israel, D M; Mahdi, G; Hassall, E

    2001-11-01

    Delayed gastric emptying may manifest with symptoms of epigastric pain, early satiety and delayed vomiting, and at times may be associated with failure to thrive. These symptoms and signs may improve following surgical pyloroplasty. To determine whether pyloric balloon dilation (PBD) is an effective therapy for children with these symptoms, hospital records of all children who underwent endoscopic PBD between October 1991 and March 1994 at British Columbia's Children's Hospital were reviewed. Excluded were children with chromosomal abnormalities, neurological disorders and erosive esophagitis. Through-the-scope balloons of diameter 15 or 18 mm were positioned in the pyloric channel and inflated with air to 2334 or 1815 mmHg respectively, for 2 min. Nineteen children with a mean age of 3.75 years (range eight months to 10 years) who presented with symptoms for more than three months (mean 11 months) were identified. Eleven children presented with failure to thrive, 14 with delayed vomiting and 10 with early satiety. Results of gastric emptying tests at 90 min ranged from 8% to 75% (mean 32%). The pylorus was difficult to intubate in 11 of 19 children, and in two the pylorus could not be passed before PBD. No complications were experienced with PBD. Thirteen children had complete resolution of symptoms, and five had transient improvement lasting four to eight weeks after PBD with subsequent complete resolution of symptoms following surgical pyloroplasty. One child continued to have mild symptoms after PBD but did not have further treatment. This study suggests that PBD is a safe and effective therapeutic option in children with symptoms and signs associated with delayed gastric emptying. PMID:11727002

  18. Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease

    PubMed Central

    Sakakibara, Ryuji; Kishi, Masahiko; Ogawa, Emina; Tateno, Fuyuki; Uchiyama, Tomoyuki; Yamamoto, Tatsuya; Yamanishi, Tomonori

    2011-01-01

    Bladder dysfunction (urinary urgency/frequency), bowel dysfunction (constipation), and sexual dysfunction (erectile dysfunction) (also called “pelvic organ” dysfunctions) are common nonmotor disorders in Parkinson's disease (PD). In contrast to motor disorders, pelvic organ autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions) and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus) are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and “prokinetic” drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life. PMID:21918729

  19. Lack of intestinal pacemaker (C-KIT-positive) cells in infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    Atsuyuki Yamataka; Toshio Fujiwara; Yoshifumi Kato; Tadaharu Okazaki; Masakatsu Suhagawa; Takeshi Miyano

    1996-01-01

    The pathogenesis of infantile hypertrophic pyloric stenosis (IHPS) is not well understood. Recent studies have shown that the protooncogene c-kit is essential for the development or maintenance of autonomic gut motility, and also show that the c-kit gene protein product (C-KIT) positive cells in the mammalian gut are responsible for intestinal pacemaker activity. This study examines cells in the pyloric

  20. Single-nucleotide promoter polymorphism alters transcription of neuronal nitric oxide synthase exon 1c in infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    Dieter Saur; Jean-Marie Vanderwinden; Barbara Seidler; Roland M. Schmid; Marc-Henri de Laet; Hans-Dieter Allescher

    2004-01-01

    Infantile hypertrophic pyloric stenosis (IHPS), characterized by enlarged pyloric musculature and gastric-outlet obstruction, is associated with altered expression of neuronal nitric oxide synthase (nNOS). Here we have studied molecular mechanisms by which nNOS gene expression is altered in pyloric tissues of 16 infants with IHPS and 9 controls. A significant decreased expression of total nNOS mRNA was found by quantitative

  1. Designing micro- and nanostructures for artificial urinary sphincters

    NASA Astrophysics Data System (ADS)

    Weiss, Florian M.; Deyhle, Hans; Kovacs, Gabor; Müller, Bert

    2012-04-01

    The dielectric elastomers are functional materials that have promising potential as actuators with muscle-like mechanical properties due to their inherent compliancy and overall performance: the combination of large deformations, high energy densities and unique sensory capabilities. Consequently, such actuators should be realized to replace the currently available artificial urinary sphincters building dielectric thin film structures that work with several 10 V. The present communication describes the determination of the forces (1 - 10 N) and deformation levels (~10%) necessary for the appropriate operation of the artificial sphincter as well as the response time to master stress incontinence (reaction time less than 0.1 s). Knowing the dimensions of the presently used artificial urinary sphincters, these macroscopic parameters form the basis of the actuator design. Here, we follow the strategy to start from organic thin films maybe even monolayers, which should work with low voltages but only provide small deformations. Actuators out of 10,000 or 100,000 layers will finally provide the necessary force. The suitable choice of elastomer and electrode materials is vital for the success. As the number of incontinent patients is steadily increasing worldwide, it becomes more and more important to reveal the sphincter's function under static and stress conditions to realize artificial urinary sphincters, based on sophisticated, biologically inspired concepts to become nature analogue.

  2. Mathematical Modeling of Subthreshold Resonant Properties in Pyloric Dilator Neurons

    PubMed Central

    Vazifehkhah Ghaffari, Babak; Kouhnavard, Mojgan; Aihara, Takeshi; Kitajima, Tatsuo

    2015-01-01

    Various types of neurons exhibit subthreshold resonance oscillation (preferred frequency response) to fluctuating sinusoidal input currents. This phenomenon is well known to influence the synaptic plasticity and frequency of neural network oscillation. This study evaluates the resonant properties of pacemaker pyloric dilator (PD) neurons in the central pattern generator network through mathematical modeling. From the pharmacological point of view, calcium currents cannot be blocked in PD neurons without removing the calcium-dependent potassium current. Thus, the effects of calcium (ICa) and calcium-dependent potassium (IKCa) currents on resonant properties remain unclear. By taking advantage of Hodgkin-Huxley-type model of neuron and its equivalent RLC circuit, we examine the effects of changing resting membrane potential and those ionic currents on the resonance. Results show that changing the resting membrane potential influences the amplitude and frequency of resonance so that the strength of resonance (Q-value) increases by both depolarization and hyperpolarization of the resting membrane potential. Moreover, hyperpolarization-activated inward current (Ih) and ICa (in association with IKCa) are dominant factors on resonant properties at hyperpolarized and depolarized potentials, respectively. Through mathematical analysis, results indicate that Ih and IKCa affect the resonant properties of PD neurons. However, ICa only has an amplifying effect on the resonance amplitude of these neurons. PMID:25960999

  3. Molecular cytogenetic characterisation of partial trisomy 9q in a case with pyloric stenosis and a review

    Microsoft Academic Search

    Anita Heller; J Seidel; A Hübler; H Starke; V Beensen; G Senger; M Rocchi; J Wirth; I Chudoba; U Claussen; T Liehr

    2000-01-01

    Partial trisomy 9q represents a rare and heterogeneous group of chromosomal aberrations characterised by various clinical features including pyloric stenosis. Here, we describe the case of a 1 year old female patient with different dysmorphic features including pyloric stenosis and prenatally detected partial trisomy 9q. This partial trisomy 9q has been analysed in detail to determine the size of the

  4. The Effect of Propofol on the Canine Sphincter of Oddi

    PubMed Central

    Dalton, C. B.; Cotton, P. B.; May, G. R.; Milton, L. G.; Chari, R. S.; Meyers, W. C.

    1994-01-01

    To assess the effect of propofol on the canine sphincter of Oddi (SO), sphincter of Oddi manometry (SOM) was performed in fasting dogs which had undergone cholecystectomy and placement of modified Thomas duodenal cannulae. Using two water-perfused, single-lumen manometric catheters, SO and duodenal pressures were measured simultaneously. Baseline SO activity was recorded for at least one complete interdigestive cycle followed by bolus injections of propofol (Diprivan ®) (N = 31) from 0.1 to 4.0 mg/kg during Phase I of the Migrating Motor Complex (MMC). When propofol was administered in bolus doses ? 0.5 mg/kg, no change in SO or duodenal motor function was seen. In doses ? 0.5 mg/kg, SO basal pressure, amplitude, and frequency of contractions increased significantly. Increases in duodenal activity paralleled SO activity. Our results suggest that propofol in low doses may be useful for sedation during Sphincter of Oddi manometry in humans. Further studies of the effects of propofol on the human sphincter of Oddi are warranted. PMID:8204549

  5. Thermal responses of shape memory alloy artificial anal sphincters

    NASA Astrophysics Data System (ADS)

    Luo, Yun; Takagi, Toshiyuki; Matsuzawa, Kenichi

    2003-08-01

    This paper presents a numerical investigation of the thermal behavior of an artificial anal sphincter using shape memory alloys (SMAs) proposed by the authors. The SMA artificial anal sphincter has the function of occlusion at body temperature and can be opened with a thermal transformation induced deformation of SMAs to solve the problem of severe fecal incontinence. The investigation of its thermal behavior is of great importance in terms of practical use in living bodies as a prosthesis. In this work, a previously proposed phenomenological model was applied to simulate the thermal responses of SMA plates that had undergone thermally induced transformation. The numerical approach for considering the thermal interaction between the prosthesis and surrounding tissues was discussed based on the classical bio-heat equation. Numerical predictions on both in vitro and in vivo cases were verified by experiments with acceptable agreements. The thermal responses of the SMA artificial anal sphincter were discussed based on the simulation results, with the values of the applied power and the geometric configuration of thermal insulation as parameters. The results obtained in the present work provided a framework for the further design of SMA artificial sphincters to meet demands from the viewpoint of thermal compatibility as prostheses.

  6. Obstetrics anal sphincter injury and repair technique: a review.

    PubMed

    Temtanakitpaisan, Teerayut; Bunyacejchevin, Suvit; Koyama, Masayasu

    2015-03-01

    The Urogynecology Committee of the Asia and Oceania Federation of Obstetrics and Gynaecology (AOFOG) has held seminars and workshops on various urogynecological problems in each country in the Asia-Oceania area in order to encourage young obstetricians and gynecologists. In 2013, we organized the operative seminar for obstetrical anal sphincter injuries (OASIS) in which we prepared porcine models to educate young physicians in a hands-on workshop at the 23rd Asian and Oceanic Congress of Obstetrics and Gynaecology in Bangkok, Thailand. Laceration of the anal sphincter mostly occurs during vaginal delivery and it can develop into anal sphincter deficiency, which causes fecal incontinence, if an appropriate suture is not performed. OASIS has become an important issue, especially in developing countries. The prevalence of OASIS of more than the third degree is around 5% in primary parous women and the frequency is higher when detected by ultrasonographic evaluation. Several risk factors, such as macrosomia, instrumental labor, perineal episiotomy and high maternal age, have been recognized. In a society where pregnant women are getting older, OASIS is becoming a more serious issue. An intrapartum primary appropriate stitch is important, but the 1-year outcome of a delayed operation after 2 weeks postpartum is similar. A randomized controlled study showed that overlapping suture of the external sphincter is better than that of end-to-end surgical repair. The Urogynecology Committee of the AOFOG would like to continue with educative programs about the appropriate therapy for OASIS. PMID:25545893

  7. Sphincter denervation in anorectal incontinence and rectal prolapse

    Microsoft Academic Search

    A G Parks; M Swash; H Urich

    1977-01-01

    Biopsies of the external anal sphincter, puborectalis, and levator ani muscles have been examined in 24 women and one man with long-standing anorectal incontinence, 18 of whom also had rectal prolapse, and in two men with rectal prolapse alone. In 16 of the women anorectal incontinence was of unknown cause, but in eight there was a history of difficult labour.

  8. Question of an infectious etiology or contribution to the pathogenesis of infantile hypertrophic pyloric stenosis.

    PubMed

    Modarressi, Taher

    2014-05-01

    Infantile hypertrophic pyloric stenosis is a concerning cause of nonbilious vomiting in the neonatal population. Although a number of etiological theories exist, its exact cause remains nebulous. The question of an infectious etiology (or contribution) has been previously examined in case reports and case series, with recent support through suggestions of seasonality and familial aggregation with unclear inheritance patterns. The present review discusses the published literature regarding infectious etiologies of infantile hypertrophic pyloric stenosis. Furthermore, it attempts to demonstrate that newer research regarding an NOS1 genetic etiology does not exclude, but rather can be consistent with, an infectious etiology. PMID:24345839

  9. Olive without a cause: the story of infantile hypertrophic pyloric stenosis.

    PubMed

    Markowitz, Richard I

    2014-02-01

    For many diseases and medical conditions the clinical recognition and the development of accurate diagnostic methods and the etiological cause precede effective treatment. In the case of infantile hypertrophic pyloric stenosis (HPS), this sequence of events did not happen. Clinical recognition of the entity proceeded directly to the development of curative treatment. Reliable diagnostic imaging methods followed, but a definitive etiology has not been elucidated. This paper reviews the historical aspects of hypertrophic pyloric stenosis, discusses how and why it took so long for this not uncommon disease to be recognized, and highlights the physicians who changed an often fatal disease into an easily diagnosed and treated minor affliction. PMID:24281686

  10. Sphincter-sparing techniques for fistulas-in-ano.

    PubMed

    Pommaret, E; Benfredj, P; Soudan, D; de Parades, V

    2015-04-01

    Anal fistulas require surgical treatment to cure the fistula. Fistulotomy is the treatment of choice because of its high success rate, but it also carries a risk of postoperative incontinence. Different methods have been proposed to overcome the need for dividing part or all of the sphincter, so-called "sphincter saving techniques" (SST), such as flap advancement, intrafistular injection of glue, or the insertion of a bio-prosthesis (collagen plug). However, the success rate of SSTs is lower than that of fistulotomy. Ligation of the Intersphincteric Fistula Tract (LIFT) is one of the most recent SSTs. It aims to ligate and transect the fistula by an approach through the intersphincteric space. The methodological quality of most published studies has been only average, but several studies have reported attractive success rates of 70 to 95% without postoperative incontinence. Other techniques such as endo-anal clip or injection of autologous stem cells are still anecdotal. PMID:25280598

  11. Audit of results of operations for infantile pyloric stenosis in a district general hospital

    Microsoft Academic Search

    C A Eriksen; C J Anders

    1991-01-01

    Because of the proposal that infants with hypertrophic pyloric stenosis should only be treated by surgeons with an interest in paediatric surgery, we carried out a retrospective study to audit our experience in a district general hospital. Forty six infants over a five year period underwent pyloromyotomy. There were no deaths, and 36 infants (78%) made uneventful recoveries. Perforation of

  12. Prostaglandin-induced foveolar hyperplasia simulating pyloric stenosis in an infant with cyanotic heart disease

    Microsoft Academic Search

    M. G. Mercado-Deane; E. M. Burton; A. V. Brawley; R. Hatley

    1994-01-01

    Prostaglandin infusion is used to maintain patency of the ductus arteriosus in infants with cyanotic congenital heart disease. Recently, gastric outlet obstruction as a result of prostaglandin infusion has been described. In our case, an upper gastrointestinal contrast study seemed to depict the typical appearance of pyloric stenosis in an infant who had received an infusion of prostaglandin for a

  13. Laparoscopic extramucosal pyloromyotomy versus open pyloromyotomy for infantile hypertrophic pyloric stenosis: Which is better?

    Microsoft Academic Search

    Takao Fujimoto; Osamu Segawa; Saori Esaki; Takeshi Miyano

    1999-01-01

    Background\\/Purpose: The aim of this study was to evaluate the advantages or disadvantages of laparoscopic pyloromyotomy compared with open transumbilical fold pyloromyotomy.Methods: Thirty consecutive laparoscopic extramucosal pyloromyotomies (LP) performed from 1994 to 1997 were compared with 30 consecutive open pyloromyotomies (OP) performed during the same period with regard to age at operation, body weight, thickness of hypertrophied pyloric muscle, operating

  14. Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis: Report of 11 cases

    Microsoft Academic Search

    Kevin L. Greason; W. Raleigh Thompson; Earl C. Downey; Barry Lo Sasso

    1995-01-01

    Pyloromyotomy remains the standard of care for the treatment of infantile hypertrophic pyloric stenosis. Open pyloromyotomy is effective and is the gold-standard technique. The authors report on the technique of laparoscopic pyloromyotomy. The clinical courses of the first 11 infants treated with laparoscopic pyloromyotomy were compared with the courses of 14 infants treated recently with open pyloromyotomy. The average surgical

  15. Pneumatosis intestinalis presenting as pneumoperitoneum in a teenage girl with pyloric stenosis.

    PubMed

    Wong, C W Y; Chung, P H Y; Wong, K K Y; Tam, P K

    2015-01-01

    A 16-year-old girl presented with free gas under the diaphragm after endoscopic balloon dilation for pyloric stenosis. There was no perforation site identified on laparotomy. However, there was massive pneumatosis intestinalis involving the entire small bowel. PMID:25721833

  16. Hypertrophic Pyloric Stenosis developing In a Patient Operated for Patent Urachus - A Case Report.

    PubMed

    Jangid, Manoj Kumar; Khan, Yousuf Aziz; Yadav, Sunil Kumar; Taqi, Esmaeel

    2014-05-01

    A neonate with patent urachus (PU) who later developed hypertrophic pyloric stenosis (HPS) is being reported. The newborn was first operated for PU; post-operatively he developed persistent vomiting and radiological workup confirmed HPS. Pyloromyotomy was performed with an uneventful recovery. PMID:25057473

  17. Dominantly-inherited polycystic kidneys in infants: Association with hypertrophic pyloric stenosis

    Microsoft Academic Search

    J. P. Loh; J. O. Haller; E. G. Kassner; A. Aloni; K. Glassberg

    1977-01-01

    Newborn male fraternal twins presented at 10 days of age with bilateral flank masses; intravenous urograms showed polycystic kidney disease. Both babies also had hypertrophic pyloric stenosis (HPS). Their father has radiographic and sonographic findings of previously unsuspected polycystic kidneys and has a history of HPS in infancy. The association of dominantly-inherited polycystic kidneys (DPK) and HPS in this family

  18. Pyloric stenosis in a patient with pure esophageal atresia: A difficult diagnosis.

    PubMed

    Chattopadhyay, Anindya

    2014-04-01

    Hypertrophic pyloric stenosis is brought to attention by its characteristic non-bilious vomiting. In a patient with pure esophageal atresia and a feeding gastrostomy, the symptoms were modified and the diagnosis was delayed. This case report highlights the clinical features of this rare combination, whose diagnosis was easily established once the entity was considered. PMID:24741218

  19. A rare occurrence of pyloric stenosis in an infant with osteogenesis imperfecta: Anesthetic implications.

    PubMed

    Jagtap, Sheetal R; Bakhshi, Rochana G; Jain, Ankit

    2014-04-01

    Congenital anomalies pose many challenges during anesthesia due to anatomic and physiological alterations. The inherent complications associated with the disorders necessitate vigilance for providing anesthesia to even seemingly simple surgical intervention. Here, we share our experience of anesthesia management of an infant of congenital osteogenesis imperfecta with pyloric stenosis for pyloromyotomy. PMID:24803772

  20. Long-term outcome of endoscopic dilation of nonmalignant pyloric stenosis

    Microsoft Academic Search

    Scott K. Kuwada; Glenn L. Alexander

    1995-01-01

    Although the immediate success of endoscopic balloon dilation of nonmalignant and noncongenital pyloric stenosis is known, little information is available on the long-term results of such therapy. Of 19 patients who underwent this treatment at our institution for gastric outlet obstruction, 3 (16%) experienced sustained relief and 16 (84%) had a recurrence of symptoms during a median follow-up period of

  1. Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: Impact of experience on the results in 182 cases

    Microsoft Academic Search

    J. D. W. van der Bilt; W. L. M. Kramer; D. C. van der Zee; N. M. A. Bax

    2004-01-01

    Background There has been discussion about the value of laparoscopic pyloromyotomy (LP) for the treatment of hypertrophic pyloric stenosis (HPS). In their initial small series, the authors reported a relatively high complication rate. The current study was undertaken to investigate the influence of experience with LP on operative time, complication rate, and postoperative hospital stay for a large number of

  2. Endocrine cells in the antro-pyloric mucosa of the stomach

    Microsoft Academic Search

    E. Solcia; G. Vassallo; R. Sampietro

    1967-01-01

    A type of endocrine-like cell displaying all morphological features of protein secreting cells, has been found in the antro-pyloric mucosa of the stomach of mammals. Light and electron microscopy observations provide a sharp distinction of this cell from the 5-hydroxytryptamine-storing enterochromaffin cell. Its possible involvement in the secretion of a protein or peptide hormone is discussed.

  3. A Case of an Ectopic Ampulla of Vater in the Pyloric Channel

    PubMed Central

    Wang, Xiao Jing; Qayed, Emad

    2014-01-01

    A 51-year-old male presented with abdominal pain and jaundice. He was subsequently diagnosed with cholestatic jaundice and cholangitis. A side-viewing duodenoscope failed to identify the ampulla of Vater in the second portion of duodenum. A regular gastroscope was used, and an ectopic ampulla of Vater was identified in the pyloric channel.

  4. Stress Urinary Incontinence Secondary to Intrinsic Sphincteric Deficiency

    Microsoft Academic Search

    Robert W. Frederick; Gary E. Leach

    Surgical management of stress urinary incontinence (SUI) has evolved over the last 20 years. Numerous procedures have been\\u000a introduced and modifications to established procedures have been reported in the literature. Our understanding of the female\\u000a continence mechanism has evolved as well. Currently, female SUI is attributed to urethral hypermobility, intrinsic sphincteric\\u000a deficiency (ISD), or a combination of both conditions. This

  5. Does surgery correct esophageal motor dysfunction in gastroesophageal reflux

    SciTech Connect

    Russell, C.O.; Pope, C.E.; Gannan, R.M.; Allen, F.D.; Velasco, N.; Hill, L.D.

    1981-09-01

    The high incidence of dysphagia in patients with symptomatic gastroesophageal reflux (GER) but no evidence of peptic stricture suggests esophageal motor dysfunction. Conventional methods for detecting dysfunction (radiologic and manometric examinations) often fail to detect abnormality in these patients. Radionuclide transit (RT), a new method for detecting esophageal motor dysfunction, was used to prospectively assess function in 29 patients with symptomatic GER uncomplicated by stricture before and three months after antireflux surgery (HILL). The preoperative incidence of dysphagia and esophageal dysfunction was 73% and 52%, respectively. During operation (Hill repair), intraoperative measurement of the lower esophageal sphincter pressure was performed and the LESP raised to levels between 45 and 55 mmHg. The preoperative lower esophageal sphincter pressure was raised from a mean of 8.6 mmHg, to mean of 18.5 mmHg after operation. No patient has free reflux after operation. Postoperative studies on 20 patients demonstrated persistence of all preoperative esophageal dysfunction despite loss of dysphagia. RT has demonstrated a disorder of esophageal motor function in 52% of patients with symptomatic GER that may be responsible for impaired esophageal clearance. This abnormality is not contraindication to surgery. The results indicate that construction of an effective barrier to reflex corrects symptoms of reflux, even in the presence of impaired esophageal transit. Radionuclide transit is a safe noninvasive test for assessment of esophageal function.

  6. Diastolic dysfunction.

    PubMed

    Jeong, Euy-Myoung; Dudley, Samuel C

    2015-01-01

    Despite the growing number of patients affected, the understanding of diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF) is still poor. Clinical trials, largely based on successful treatments for systolic heart failure, have been disappointing, suggesting that HFpEF has a different pathology to that of systolic dysfunction. In this review, general concepts, epidemiology, diagnosis, and treatment of diastolic dysfunction are summarized, with an emphasis on new experiments suggesting that oxidative stress plays a crucial role in the pathogenesis of at least some forms of the disease. This observation has lead to potential new diagnostics and therapeutics for diastolic dysfunction and heart failure caused by diastolic dysfunction. PMID:25746522

  7. Outcome after treatment of detrusor–sphincter dyssynergia by temporary stent

    Microsoft Academic Search

    E Chartier-Kastler; N Ayoub; A Even-Schneider; F Richard; P Denys

    2008-01-01

    Objectives:To evaluate follow-up treatments used after treatment of detrusor–sphincter dyssynergia (DSD) by a temporary urethral sphincter stent.Materials and methods:Between February 1994 and June 2003, 147 men with a mean age of 41.3±14.4 years were treated by temporary urethral stent inserted across the external sphincter for DSD. The underlying neurologic disease was quadriplegia in 85 cases, multiple sclerosis in 24 cases

  8. Hepatic dysfunction.

    PubMed

    McCord, Kelly W; Webb, Craig B

    2011-07-01

    This article reviews the common pathophysiology that constitutes hepatic dysfunction, regardless of the inciting cause. The systemic consequences of liver failure and the impact of this condition on other organ systems are highlighted. The diagnostic tests available for determining the cause and extent of liver dysfunction are outlined, treatment strategies aimed at supporting hepatic health and recovery are discussed, and prognosis is briefly covered. The article emphasizes the fact that because of the central role of the liver in maintaining normal systemic homeostasis, hepatic dysfunction cannot be effectively addressed as an isolated entity. PMID:21757090

  9. Investigation of cholecystokinin receptors in the human lower esophageal sphincter

    PubMed Central

    Liu, Jun-Feng; Zhang, Jian; Liu, Xin-Bo; Drew, Paul A

    2014-01-01

    AIM: To compare the binding of cholecystokinin (CCK)-8 to CCK receptors in sling and clasp fibers of the human lower esophageal sphincter. METHODS: Esophageal sling and clasp fibers were isolated from eight esophagectomy specimens, resected for squamous cell carcinoma in the upper two thirds of the esophagus, which had been maintained in oxygenated Kreb’s solution. Western blot was used to measure CCK-A and CCK-B receptor subtypes in the two muscles. A radioligand binding assay was used to determine the binding parameters of 3H-CCK-8S to the CCK receptor subtypes. The specificity of binding was determined by the addition of proglumide, which blocks the binding of CCK to both receptor subtypes. RESULTS: There was no significant difference between the sling and clasp fibers of the human lower esophageal sphincter in the amount of CCK-A [integrated optical density (IOD) value: 22.65 ± 0.642 vs 22.328 ± 1.042, P = 0.806] or CCK-B receptor protein (IOD value: 13.20 ± 0.423 vs 12.45 ± 0.294, P = 0.224) as measured by Western blot. The maximum binding of radio-labeled CCK-8S was higher in the sling fibers than in the clasp fibers (595.75 ± 3.231 cpm vs 500.000 ± 10.087 cpm, P < 0.001) and dissociation constant was lower (Kd: 1.437 ± 0.024 nmol/L vs 1.671 ± 0.024 nmol/L, P < 0.001). The IC50 of the receptor specific antagonists were lower for the CCK-A receptors than for the CCK-B (P < 0.01). CONCLUSION: CCK binding modulates the contractile function of the lower esophageal sphincter through differential binding to the CCK-A receptor on the sling and clasp fibers. PMID:24914377

  10. The effect of solifenacin on urethral sphincter morphology

    Microsoft Academic Search

    Jonathan Duckett; Maya Basu

    2011-01-01

    Introduction and hypothesis  The aim of the study was to determine whether a 6-week course of 5 mg of solifenacin succinate used to treat mixed incontinence,\\u000a produces measurable changes in the appearance of the urethral sphincter.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Twenty-six women undergoing treatment for mixed incontinence were recruited from a urogynaecology unit after failing to improve\\u000a with conservative treatments and bladder drill. All underwent dual

  11. Effect of cholesterol liposomes on calcium mobilization in muscle cells from the rabbit sphincter of Oddi

    Microsoft Academic Search

    Xin-Jiang Wang; Jing-Guo Wei; Chun-Mei Wang; Yao-Cheng Wang; Qiu-Zhen Wu; Jia-Kuan Xu; Xiang-Xin Yang

    AIM: To analyze the influence of cholesterol liposome on the Ca 2+ mobilization of cultured muscle cells in rabbit sphincter of Oddi's. METHODS: New Zealand rabbit was sacrificed and the sphincter of Oddi (SO) segement was obtained aseptically. The SO segment was cut into pieces and cultured in DMEM solution. Then the smooth muscle cells were subcultured, and the 4th-7th

  12. Muscle precursor cells for the restoration of irreversibly damaged sphincter function.

    PubMed

    Eberli, Daniel; Aboushwareb, Tamer; Soker, Shay; Yoo, James J; Atala, Anthony

    2012-01-01

    Multiple modalities, including injectable bulking agents and surgery, have been used to treat stress urinary incontinence. However, none of these methods is able to fully restore normal striated sphincter muscle function. In this study, we explored the possibility of achieving functional recovery of the urinary sphincter muscle using autologous muscle precursor cells (MPCs) as an injectable, cell-based therapy. A canine model of striated urinary sphincter insufficiency was created by microsurgically removing part of the sphincter muscle in 24 dogs. Autologous MPCs were obtained, expanded in culture, and injected into the damaged sphincter muscles of 12 animals. The animals were followed for up to 6 months after injection, and urodynamic studies, functional organ bath studies, ultrastructural and histological examinations were performed. Animals receiving MPC injections demonstrated sphincter pressures of approximately 80% of normal values, while the pressures in the control animals without cells dropped and remained at 20% of normal values. Histological analysis indicated that the implanted cells survived and formed tissue, including new innervated muscle fibers, within the injected region of the sphincter. These results indicate that autologous muscle precursor cells may be able to restore otherwise irreversibly damaged urinary sphincter function clinically. PMID:22236637

  13. Nissen fundoplication has a vagolytic effect on the lower esophageal sphincter

    Microsoft Academic Search

    B. Sarani; T. Chan; R. Wise; S. Evans

    2003-01-01

    Background: Laparoscopic Nissen fundoplication is an increasingly utilized option for the treatment of gastroesophageal reflux disease (GERD). However, many questions remain as to the mechanism by which this operation prevents GERD in those without hiatal hernias or incompetent lower esophageal sphincters (LES). It is known that these patients experience reflux due to excess transient lower esophageal sphincter relaxations (TLESR), inappropriate

  14. Prognostic Factors for Recurrence of Bile Duct Stones after Endoscopic Treatment by Sphincter Dilation

    Microsoft Academic Search

    Norio Ueno; Yoshifumi Ozawa; Toshiyuki Aizawa

    2003-01-01

    Background:The long-term outcome for patients after endoscopic sphincter of Oddi dilation is poorly documented. This study investigates the recurrence rate for bile duct stones in patients followed for 1 year or more after endoscopic sphincter dilation and stone extraction, and assessed prognostic factors associated with recurrence of ductal calculi.

  15. Preliminary investigation of the pharmacology of the human internal anal sphincter

    Microsoft Academic Search

    A. G. Parks; D. J. Fishlock; J. D. H. Cameron; H. May

    1969-01-01

    The smooth muscle from the human internal anal sphincter has been investigated pharmacologically in vitro. The upper and lower parts of the sphincter responded to catecholamines in a similar manner. Noradrenaline caused contraction which could be antagonized by phenoxybenzamine. After phenoxybenzamine, noradrenaline caused relaxation which could be blocked by pronethalol. Isoprenaline caused relaxation which could be specifically prevented by pronethalol.

  16. Surgery Insight: surgical management of postprostatectomy incontinence—the artificial urinary sphincter and male sling

    Microsoft Academic Search

    Craig V Comiter

    2007-01-01

    Stress urinary incontinence in men is usually a result of intrinsic sphincter deficiency following prostate cancer surgery. Active conservative management with fluid restriction, medication management and pelvic floor exercises is indicated for the first 12 months. If bothersome incontinence persists, urodynamic evaluation is indicated in order to assess detrusor storage function, contractility and sphincteric integrity. Standard surgical options include urethral

  17. Anal sphincter repair for obstetric injury: Manometric evaluation of functional results

    Microsoft Academic Search

    James W. Fleshman; Zeev Dreznik; Robert D. Fry; Ira J. Kodner

    1991-01-01

    Anal manometry before and after surgical repair on a homogeneous group of patients with anterior sphincter defect caused by obstetric injury defined the parameters affected by the repair to achieve anal continence. Between November 1985 and April 1989, 28 patients who underwent anterior anal sphincter reconstruction were studied using anal manometry and were graded for continence. Anal function was improved

  18. Effect of modern analgesic drugs (tramadol, pentazocine, and buprenorphine) on the bile duct sphincter in man

    Microsoft Academic Search

    M Staritz; T Poralla; M Manns; K H Meyer Zum Büschenfelde

    1986-01-01

    Modern narcotic analgesic drugs, such as tramadol, pentazocine, and buprenorphine share similarities of molecular structure with morphine which is widely believed to cause spasm of the bile duct sphincter and so impede bile flow. This study assessed the effects of intravenously administered analgesics on bile duct sphincter motor activity measured by ERCP manometry. Ten minutes after pentazocine injection the duration

  19. Intraurethral ultrasound: diagnostic evaluation of the striated urethral sphincter in incontinent females.

    PubMed

    Frauscher, F; Helweg, G; Strasser, H; Enna, B; Klauser, A; Knapp, R; Colleselli, K; Bartsch, G; Zur Nedden, D

    1998-01-01

    The aim of our study was to evaluate the striated urethral sphincter (rhabdosphincter) in incontinent females by means of intraurethral ultrasound (IUUS). Thirty-four incontinent and 11 continent female patients were examined by means of 12.5-MHz endoluminal ultrasound (US). The distance between the inner contour of the sphincter muscle and the US catheter was measured in the contracted and the non-contracted condition. The US findings were correlated with those obtained by urodynamic studies. Partial or complete loss of sphincter function was detected in patients with stress urinary incontinence (SUI). Reduced sphincter function was not observed in patients with urge incontinence and continent volunteers. The findings on US were found to correlate well with the grade of SUI. The IUUS technique offers the benefit of direct visualization of the sphincter mechanism. Therefore, endoluminal US may become an important adjunct in the diagnostic evaluation of SUI and will possibly provide new insights for a better therapeutic strategy. PMID:9442128

  20. Safety and efficacy of a partially covered self-expandable metal stent in benign pyloric obstruction

    PubMed Central

    Heo, Jun; Jung, Min Kyu

    2014-01-01

    AIM: To evaluate the safety and efficacy of partially covered self-expandable metallic stents (SEMSs) in benign pyloric obstruction. METHODS: We retrospectively analyzed data from 10 consecutive patients with peptic ulcer-related pyloric obstructive symptoms (gastric outlet obstruction scoring system (GOOSS) score of 1) between March 2012 and September 2013. The patients were referred to and managed by partially covered SEMS insertion in our tertiary academic center. We assessed the technical success, symptom improvement, and adverse events after stenting. RESULTS: Early symptoms were improved just 3 d after SEMS placement in all 10 patients. The GOOSS score of all patients improved from 1 to 3. There were no serious immediate adverse events. The overall rate of being symptom free was 90% at a median of 11 mo of follow-up (range: 4-43 mo). Five patients were managed by a rescue SEMS because of failure of previous endoscopic balloon dilatation. Among them, four patients had sustained symptom improvement after the SEMS procedure. During the follow-up period, migration of the SEMS was observed in two patients (20.0%), both of whom had previous endoscopic balloon dilatation before SEMS insertion. CONCLUSION: Despite the small number in this study, partially covered SEMSs showed a favorable and safe outcome in the treatment of naïve benign pyloric obstruction and in salvage treatment after balloon dilatation failure. PMID:25469043

  1. The relation of sensation in the anal canal to the functional anal sphincter: a possible factor in anal continence

    Microsoft Academic Search

    H. L. Duthie; R. C. Bennett

    1963-01-01

    In normal subjects the length of the functional anal sphincter has been compared with the extent of sensation to light touch in the anal canal. At rest, the sphincteric zone was the longer. On distension of the rectum, a decrease in pressure in the anal canal so shortened the functional sphincter that intrarectal pressure extended down to contact the sensory

  2. Treatment of Gastrointestinal Sphincters Spasms with Botulinum Toxin A

    PubMed Central

    Brisinda, Giuseppe; Sivestrini, Nicola; Bianco, Giuseppe; Maria, Giorgio

    2015-01-01

    Botulinum toxin A inhibits neuromuscular transmission. It has become a drug with many indications. The range of clinical applications has grown to encompass several neurological and non-neurological conditions. One of the most recent achievements in the field is the observation that botulinum toxin A provides benefit in diseases of the gastrointestinal tract. Although toxin blocks cholinergic nerve endings in the autonomic nervous system, it has also been shown that it does not block non-adrenergic non-cholinergic responses mediated by nitric oxide. This has promoted further interest in using botulinum toxin A as a treatment for overactive smooth muscles and sphincters. The introduction of this therapy has made the treatment of several clinical conditions easier, in the outpatient setting, at a lower cost and without permanent complications. This review presents current data on the use of botulinum toxin A in the treatment of pathological conditions of the gastrointestinal tract. PMID:26035487

  3. Visual Dysfunction

    Microsoft Academic Search

    Robert L. Rodnitzky

    Various abnormalities of visual function have been documented in Parkinson’s disease (PD). Levodoparesponsive abnormalities\\u000a of visual-evoked potentials (VEP) and electroretinographic patterns have been demonstrated in PD patients as well as in primates\\u000a with experimental Parkinsonism. Dopamine is found within several structures subserving vision, including the visual cortex,\\u000a lateral geniculate, and retina, but retinal dopaminergic dysfunction is likely the greatest contributor

  4. Erectile Dysfunction

    Microsoft Academic Search

    Chi-Ying Li; David Ralph

    \\u000a Erectile dysfunction (ED) is defined as the consistent inability to achieve or maintain an erection. This may affect around\\u000a 50% of men between the ages of 40 and 70, while persistent ED affects about 5% of men in their 40s, and 15–25% of men by the\\u000a age of 65 [1]. As life expectancy increases, the incidence of ED is expected

  5. Heme oxygenase-1 upregulation modulates tone and fibroelastic properties of internal anal sphincter.

    PubMed

    Krishna, Chadalavada Vijay; Singh, Jagmohan; Kumar, Sumit; Rattan, Satish

    2014-09-15

    A compromise in the internal anal sphincter (IAS) tone and fibroelastic properties (FEP) plays an important role in rectoanal incontinence. Herein, we examined the effects of heme oxygenase (HO)-1 upregulation on these IAS characteristics in young rats. We determined the effect of HO-1 upregulator hemin on HO-1 mRNA and protein expressions and on basal IAS tone and its FEP before and after HO-1 inhibitor tin protoporphyrin IX. For FEP, we determined the kinetics of the IAS smooth muscle responses, by the velocities of relaxation, and recovery of the IAS tone following 0 Ca(2+) and electrical field stimulation. To characterize the underlying signal transduction for these changes, we determined the effects of hemin on RhoA-associated kinase (RhoA)/Rho kinase (ROCK) II, myosin-binding subunit of myosin light chain phosphatase 1, fibronectin, and elastin expression levels. Hemin increased HO-1 mRNA and protein similar to the increases in the basal tone, and in the FEP of the IAS. Underlying mechanisms in the IAS characteristics are associated with increases in the genetic and translational expressions of RhoA/ROCKII, and elastin. Fibronectin expression levels on the other hand were found to be decreased following HO-1 upregulation. The results of our study show that the hemin/HO-1 system regulates the tone and FEP of IAS. The hemin/HO-1 system thus provides a potential target for the development of new interventions aimed at treatment of gastrointestinal motility disorders, specifically the age-related IAS dysfunction. PMID:25035109

  6. Laparoscopic distal gastrectomy for pyloric stenosis caused by heterotopic glands in a young female: report of a case.

    PubMed

    Tanioka, Toshiro; Matsumoto, Satoru; Takahashi, Shusaku; Ueki, Shinya; Takahashi, Masahiro; Ichihara, Shin

    2015-06-01

    A 17-year-old female was referred to our hospital with worsening dietary intake and abdominal bloating. She had epigastric fullness, but no abdominal pain. Gastrointestinal endoscopy revealed food residue and pyloric stenosis. A contrast-enhanced radiograph also showed pyloric stenosis, and gastrografin was not passed well through her pylorus. Computed tomography revealed similar findings. The biopsy results indicated hyperplasia of the gastric glands. The patient was diagnosed with a benign lesion, and underwent endoscopic balloon dilation several times. However, her stenosis worsened and we decided to perform surgery. In consideration of the cosmetic outcome, we performed laparoscopic distal gastrectomy. The postoperative course was good, and the patient was discharged on postoperative day 10. The final diagnosis was pyloric stenosis caused by heterotopic glands. No malignant lesions were found. Since gastric stenosis caused by heterotopic glands has not been reported previously, we consider this to be a very rare case. PMID:24986451

  7. Personality Dysfunction and Employment Dysfunction

    PubMed Central

    Sansone, Lori A

    2010-01-01

    According to the Diagnostic and Statistical Manual of Mental Disorders, personality disorders are characterized by functional impairment, which may unfold in the work environment. A number of empirical studies convincingly suggest that the presence of personality dysfunction has substantial negative and diffuse effects on work functioning. However, not all studies are in agreement. In addition, there may be specific mediating variables that modulate the likelihood that an individual with a personality disorder will experience work difficulties. These include the type of personality disorder, degree of neuroticism and disagreeableness, extent of social dysfunction, and severity of symptoms—all of which appear to be interrelated. Because employment generally promotes an individual's stability, further research into these variables is essential. PMID:20436770

  8. Purification and characterization of trypsin from the pyloric ceca of orange-spotted grouper, Epinephelus coioides.

    PubMed

    Liu, Chun-Hung; Shiu, Ya-Li; Hsu, Jue-Liang

    2012-06-01

    Trypsin from the pyloric ceca of orange-spotted grouper, Epinephelus coioides, was purified by fractionation with ammonium sulfate, ionic exchange, and affinity chromatography. The protein was purified 161.85-fold with a yield of 4%. Purified trypsin had an apparent molecular weight of 24 kDa according to an SDS-PAGE analysis. Optimal profiles of temperature and pH of the enzyme were 50°C and 8-10, respectively, using N?-benzoyl-L: -arginine ethyl ester as the substrate. The results of thermal and pH stability assays showed that the enzyme was stable at temperatures of up to 50°C and in the pH range of 6-8. Trypsin activity decreased with an increasing NaCl concentration (0-0.6 M). The activity of purified trypsin was effectively inhibited by a soybean trypsin inhibitor and N-p-tosyl-L: -lysine chloromethyl ketone, and was slightly inhibited by iodoacetic acid, ethylenediaminetetraacetic acid, 1-(L: -trans-epoxysuccinyl-leucylamino)-4-guanidinobutane, and pepstatin A. Protein identification of the purified protease showed that the sequences of two peptides, LGEHNI and NLDNDIML, were highly homologous to other fish trypsins. The measurement of trypsin activity in different tissues showed that the highest activity was detected in pyloric ceca, followed by anterior intestine, middle intestine, hind intestine and spleen, but very low activities were found in other tissues. An inverse relationship between the trypsin activity in four tissues of pyloric ceca, anterior intestine, middle intestine and hind intestine and fish body weight as a result of increased pepsin in stomach indicated grouper growth status was increased. PMID:22068456

  9. Intraurethral ultrasound: diagnostic evaluation of the striated urethral sphincter in incontinent females

    Microsoft Academic Search

    F. Frauscher; G. Helweg; H. Strasser; B. Enna; A. Klauser; R. Knapp; K. Colleselli; G. Bartsch; D. Zur Nedden

    1998-01-01

    .   The aim of our study was to evaluate the striated urethral sphincter (rhabdosphincter) in incontinent females by means of\\u000a intraurethral ultrasound (IUUS). Thirty-four incontinent and 11 continent female patients were examined by means of 12.5-MHz\\u000a endoluminal ultrasound (US). The distance between the inner contour of the sphincter muscle and the US catheter was measured\\u000a in the contracted and the

  10. Digital examination compared to trans-perineal ultrasound for the evaluation of anal sphincter repair

    Microsoft Academic Search

    S. A. Shobeiri; T. E. Nolan; R. Yordan-Jovet; K. T. Echols; R. R. Chesson

    2002-01-01

    Objective: To assess the adequacy of a third- or a fourth-degree laceration repair by comparing digital and trans-perineal ultrasound measurements. Method: During a 4-year period, 34 subjects without prior history of anal sphincter injury or fecal incontinence underwent ultrasound measurements of external anal sphincter muscle diameter and perineal length, which were compared to measurements obtained by digital examination. Results: Pearson's

  11. The effect of pinaverium bromide (LA 1717) on the lower oesophageal sphincter.

    PubMed

    Wöltje, M; Huchzermeyer, H

    1982-01-01

    An acute, double-blind study was carried out in 8 healthy male volunteers to investigate any effect of a new antispasmodic, pinaverium bromide, compared with placebo on the lower oesophageal sphincter. Manometric measurements showed no significant differences in resting pressures either after placebo or a therapeutic dose (200 mg) of pinaverium bromide, suggesting that the active drug does not cause any impairment of function of the lower oesophageal sphincter. PMID:7128186

  12. Dysfunctional voiding: A review of the terminology, presentation, evaluation and management in children and adults.

    PubMed

    Sinha, Sanjay

    2011-10-01

    Dysfunctional voiding (DV) is a voiding disorder characterized by dyssynergic striated sphincteric activity in the absence of a proven neurological etiology. It can present at any age with a spectrum of storage and voiding symptoms that may resemble florid neurogenic bladder. There is a striking lack of clarity regarding what this entity represents, the diagnostic methodology and treatment. The limitations of existing guideline documents are analyzed. Specifically, use of the term "habitual", the assumption that bladder changes are secondary to the outlet, the emphasis on "staccato" voiding and the implication of striated urethral sphincter are discussed. Literature shows that DV may also present with continuous slow flow or normal flow. Dyssynergia may be at the level of the striated urethral sphincter, the pelvic floor or both, better termed "striated urethral sphincter-pelvic floor complex" (SUS-PFC).A diagnostic algorithm is provided so that patients are evaluated on merit rather than on the basis of different philosophies of individual centers. High-risk markers such as hydronephrosis, vesicoureteral reflux, renal failure or marked voiding difficulty should prompt a formal urodynamics evaluation and imaging for neurological etiology. Patients with predominantly storage symptoms with incidental staccato voiding can be managed initially, on the basis of non-invasive evaluation. Conservative urotherapy including biofeedback is appropriate initial management for patients without high risk factors. Treatment and evaluation should be escalated based on response. Patients with severe DV will need treatment similar to neurogenic bladder including clean intermittent catheterization and measures to control storage pressures. PMID:22279306

  13. HEPATOCEREBRAL DYSFUNCTION

    PubMed Central

    Hofmann, William W.

    1958-01-01

    The neurological manifestations associated with acquired liver disorders of various types may present difficult diagnostic problems until the condition is far advanced. Bizarre psychological and motor disorders occur when the central nervous system is affected by liver disease. The clinical features may in some ways resemble those of Wilson's disease, but such features as remitting coma, fetor hepaticus and seizures in “cholemia,” and a Kaiser-Fleischer ring in hepatolenticular degeneration help to distinguish the two conditions. The biochemical abnormalities found in all types of hepatocerebral dysfunction may be quite similar one to another. While many studies suggest that the whole problem is simply the result of brain intoxication by a substance such as ammonia, other lines of evidence indict several factors in intermediate cerebral and liver metabolism. The treatment involves use of substances which may relieve certain blocks in biochemical processes, supplementary vitamins, low protein intake and strict avoidance of all neuro- and hepatotoxins. ImagesFigure 2. PMID:13561110

  14. Maternal and infant use of erythromycin and other macrolide antibiotics as risk factors for infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    Barbara E. Mahon; Marc B. Rosenman; Martin B. Kleiman

    2001-01-01

    Objectives: To evaluate the risk for infantile hypertrophic pyloric stenosis (IHPS) among infants prescribed systemic erythromycin, infants prescribed a course of erythromycin ophthalmic ointment, and infants whose mothers were prescribed a macrolide antibiotic during pregnancy. Study design: Retrospective cohort study of infants born at an urban hospital from June 1993 through December 1999. Results: Of 14,876 eligible infants, 43 (0.29%)

  15. Changing patterns of diagnosis and treatment of infantile hypertrophic pyloric stenosis: A clinical audit of 303 patients

    Microsoft Academic Search

    Terence S. C. Poon; An-Ling Zhang; Tim Cartmill; Daniel T. Cass

    1996-01-01

    This review of 303 patients with infantile hypertrophic pyloric stenosis (IHPS) concentrates on the influence of clinical audit on diagnosis, complications, and factors contributing to hospital stay. Although the audit has enabled improvement in care by pediatric surgeons, there has been less change in areas controlled by other specialities. During a 12-year period, the number of patients diagnosed solely by

  16. Molecular cytogenetic characterisation of partial trisomy 9q in a case with pyloric stenosis and a review

    PubMed Central

    Heller, A.; Seidel, J; Hubler, A; Starke, H; Beensen, V; Senger, G; Rocchi, M; Wirth, J; Chudoba, I; Claussen, U; Liehr, T

    2000-01-01

    Partial trisomy 9q represents a rare and heterogeneous group of chromosomal aberrations characterised by various clinical features including pyloric stenosis. Here, we describe the case of a 1 year old female patient with different dysmorphic features including pyloric stenosis and prenatally detected partial trisomy 9q. This partial trisomy 9q has been analysed in detail to determine the size of the duplication and to characterise the chromosomal breakpoints. According to the data gained by different molecular cytogenetic techniques, such as fluorescence in situ hybridisation (FISH) with whole and partial chromosome painting probes, yeast artificial chromosome (YAC) probes, and comparative genomic hybridisation (CGH), the derivative chromosome 9 can be described as dup(9)(pter?q22.1::q31.1?q22.1::q31.1? q22.1::q31.1?qter). Four breakpoint spanning YACs have been identified (y806f02, y906g6, y945f5, and y747b3) for the proximal breakpoint. According to this new case and previously published data, the recently postulated putative critical region for pyloric stenosis can be narrowed down to the subbands 9q22.1-q31.1 and is the result of either partial trisomy of gene(s) located in this region or a gene disrupted in 9q31.???Keywords: partial trisomy 9q; pyloric stenosis; FISH; CGH PMID:10882757

  17. Starvation and refeeding effects on pyloric caeca structure of Caspian salmon (Salmo trutta caspius, Kessler 1877) juvenile.

    PubMed

    Emadi Shaibani, Mina; Mojazi Amiri, Bagher; Khodabandeh, Saber

    2013-06-01

    Effect of starvation and refeeding on the structure of pyloric caeca was studied in the juveniles of Caspian Sea salmon. Juveniles (average body weight 12±0.1g) were subjected to four levels of feeding: full-fed for 6 weeks (FFF), 3 weeks fed and 3 weeks following starvation (FS), 3 weeks starved and 3 weeks fed (SF), and full-starved (SSS) for 6 weeks. Light microscopic studies showed significant reduction (p<0.05) in the enterocytes height and number, villus length, epithelial area and pyloric caeca total area in starved groups as compared to control group. These reductions were more significant (p<0.05) in long term starved group (SSS) than short term starved group (FS). Additionally, refeeding increased pyloric caeca size and enterocyte's number in SF group whereas, the epithelial total area and villus length did not reach the same area and length as control group. Results indicated that in Caspian Sea salmon juveniles food deprivation and consuming of food source, adversely affected the tissue of pyloric caeca while refeeding can be effective on healing tissue damage. PMID:23477933

  18. Preventing kidney injury in children with neurogenic bladder dysfunction.

    PubMed

    Larijani, Faezeh Javadi; Moghtaderi, Mastaneh; Hajizadeh, Nilofar; Assadi, Farahnak

    2013-12-01

    The most common cause of neurogenic bladder dysfunction (NBD) in newborn infants is myelomeningocele. The pathophysiology almost always involves the bladder detrusor sphincter dyssynergy (DSD), which if untreated can cause severe and irreversible damage to the upper and lower urinary tracts. Early diagnosis and adequate management of NBD is critical to prevent both renal damage and bladder dysfunction and to reduce chances for the future surgeries. Initial investigation of the affected newborn infant includes a renal and bladder ultrasound, measurement of urine residual, determination of serum creatinine level, and urodynamics study. Voiding cystogram is indicated when either hydronephrosis or DSD is present. The main goal of treatment is prevention of urinary tract deterioration and achievement of continuance at an appropriate age. Clean intermittent catheterization (CIC) in combination with anticholinergic (oxybutynin) and antibiotics are instituted in those with high filling and voiding pressures, DSD and/or high grade reflux immediately after the myelomeningocele is repaired. Botulium toxin-A injection into detrusor is a safe alternative in patients with insufficient response or significant side effects to anticholinergic (oral or intravesical instillation) therapy. Surgery is an effective alternative in patients with persistent detrusor hyperactivity and/or dyssynergic detrusor sphincter despites of the CIC and maximum dosage of anticholinergic therapy. Children with NBD require care from a multidisciplinary team approach consisting of pediatricians, neurosurgeon, urologist, nephrologists, orthopedic surgeon, and other allied medical specialists. PMID:24498490

  19. Medication Effects on Periurethral Sensation and Urethral Sphincter Activity

    PubMed Central

    Greer, W. Jerod; Gleason, Jonathan L.; Kenton, Kimberly; Szychowski, Jeff M.; Goode, Patricia S; Richter, Holly E

    2014-01-01

    Aim To characterize urethral neuromuscular function before and 2 weeks after medication therapy. Methods Premenopausal women without lower urinary tract symptoms were randomly allocated to one of six medications for 2 weeks (pseudoephedrine ER 120mg, imipramine 25mg, cyclobenzaprine 10mg, tamsulosin 0.4mg, solifenacin 5mg or placebo). At baseline and after medication, participants underwent testing: quantitative concentric needle EMG (CNE) of the urethral sphincter using automated Multi-Motor Unit Action Potential (MUP) software; current perception threshold (CPT) testing to measure periurethral sensation; and standard urodynamic pressure flow studies (PFS). Nonparametric tests were used to compare pre-post differences. Results 56 women had baseline testing; 48 (85.7%) completed follow-up CNE, and 49 (87.5%) completed follow-up CPT and PFS testing. Demographics showed no significant differences among medication groups with respect to age (mean 34.3 ± 10.1), BMI (mean 31.8 ± 7.5), parity (median 1, range 0–7), or race (14% Caucasian, 80% African American). PFS parameters were not significantly different within medication groups. No significant pre-post changes in CNE values were noted; however, trends in amplitudes were in a direction consistent with the expected physiologic effect of the medications. With CPT testing, a trend toward increased urethral sensation at the 5 Hz stimulation level, was observed following treatment with pseudoephedrine (0.15 to 0.09 mA at 5Hz; P=0.03). Conclusion In women without LUTS, pseudoephedrine improved urethral sensation, but not urethral neuromuscular function on CNE or pressure flow studies. Imipramine, cyclobenzaprine, tamsulosin, solifenacin, and placebo did not change urethral sensation or neuromuscular function. PMID:25185603

  20. Expression of serotonin receptors in human lower esophageal sphincter

    PubMed Central

    LI, HE-FEI; LIU, JUN-FENG; ZHANG, KE; FENG, YONG

    2015-01-01

    Serotonin (5-HT) is a neurotransmitter and vasoactive amine that is involved in the regulation of a large number of physiological functions. The wide variety of 5-HT-mediated functions is due to the existence of different classes of serotonergic receptors in the mammalian gastrointestinal tract and nervous system. The aim of this study was to explore the expression of multiple types of 5-HT receptor (5-HT1AR, 5-HT2AR, 5-HT3AR, 5-HT4R, 5-HT5AR, 5-HT6R and 5-HT7R) in sling and clasp fibers from the human lower esophageal sphincter (LES). Muscle strips of sling and clasp fibers from the LES were obtained from patients undergoing esophagogastrectomy, and circular muscle strips from the esophagus and stomach were used as controls. Reverse transcription-polymerase chain reaction (RT-PCR), quantitative PCR and western blotting were used to investigate the expression of the various 5-HT receptor types. Messenger RNA for all seven 5-HT receptor types was identified in the sling and clasp fibers of the LES. At the mRNA level, the expression levels were highest for 5-HT3AR and 5-HT4R, and lowest for 5-HT5AR, 5-HT6R and 5-HT7R. At the protein level, the expression levels were highest for 5-HT3AR and 5-HT4R, followed by 5-HT1AR and 5-HT2AR; 5-HT7R was also detected at a low level. The expression of 5-HT5AR and 5-HT6R proteins was not confirmed. The results indicate that a variety of 5-HT receptor types can be detected in the human LES and probably contribute to LES function. PMID:25452775

  1. Improvement of urethral sphincter deficiency in female rats following autologous skeletal muscle myoblasts grafting.

    PubMed

    Praud, Christophe; Sebe, Philippe; Biérinx, Anne-Sophie; Sebille, Alain

    2007-01-01

    Sphincteric deficiency is the most common cause of urinary incontinence in humans. Various treatments have lead to disappointing results due to a temporary benefit. Recent studies raised the possibility that sphincteric deficiency could be treated by implanting skeletal myoblasts. In the present study, we developed in the female rat a model of chronic sphincteric defect to assess the benefit of myoblast injection. Sphincter deficiency was induced by freezing, longitudinal sphincterotomy, and notexin injection, respectively, to obtain a reproducible and irreversible incontinence. Autologous tibialis anteriors were cultured to be injected in the best model. Functional results were evaluated by measuring the urethral pressure with an open catheter. Histology was performed in the excised urethras. Of the three techniques, only longitudinal sphincterotomy caused definitive incontinence by irreversibly destroying the striated sphincter muscle fibers: a 45% decrease of the closure pressure was observed 21 days after the sphincterotomy. At this time, we injected myoblasts at the sphincterotomy site. In the sham-injected group (n = 18), the closure pressure decrease was not significantly modified 21 days after injection. By comparison, a return to near normal value was observed after cell grafting (n = 21). These results and those obtained by others strongly suggest that the use of myoblasts could be a potential innovative therapy for urethral deficiencies leading to incontinence. PMID:18019363

  2. Mode of Vaginal Delivery: A Modifiable Intrapartum Risk Factor for Obstetric Anal Sphincter Injury

    PubMed Central

    Simó González, Marta; Porta Roda, Oriol; Perelló Capó, Josep; Gich Saladich, Ignasi; Calaf Alsina, Joaquim

    2015-01-01

    The aim of this study was to analyze the comparative risks of this anal sphincter injury in relation to the type of intervention in vaginal delivery. We performed an observational, retrospective study of all vaginal deliveries attended at a tertiary university hospital between January 2006 and December 2009. We analyzed the incidence of obstetric anal sphincter injury for each mode of vaginal delivery: spontaneous delivery, vacuum, Thierry spatulas, and forceps. We determined the proportional incidence between methods taking spontaneous delivery as the reference. Ninety-seven of 4526 (2.14%) women included in the study presented obstetric anal sphincter injury. Instrumental deliveries showed a significantly higher risk of anal sphincter injury (2.7 to 4.9%) than spontaneous deliveries (1.1%). The highest incidence was for Thierry spatulas (OR 4.804), followed by forceps (OR 4.089) and vacuum extraction (OR 2.509). The type of intervention in a vaginal delivery is a modifiable intrapartum risk factor for obstetric anal sphincter injury. Tearing can occur in any type of delivery but proportions vary significantly. All healthcare professionals attending childbirth should be aware of the risk for each type of intervention and consider these together with the obstetric factors in each case. PMID:25722727

  3. Effects of Scleroderma Antibodies and Pooled Human Immunoglobulin on Anal Sphincter and Colonic Smooth Muscle Function

    PubMed Central

    SINGH, JAGMOHAN; COHEN, SIDNEY; MEHENDIRATTA, VAIBHAV; MENDOZA, FABIAN; JIMENEZ, SERGIO A.; DIMARINO, ANTHONY J.; RATTAN, SATISH

    2012-01-01

    BACKGROUND & AIMS Patients with systemic sclerosis (SSc) have impairments in gastrointestinal smooth muscle function. The disorder has been associated with circulating antibodies to cholinergic muscarinic type-3 receptor (M3-R). We investigated whether it is possible to neutralize these antibodies with pooled human immunoglobulin (Ig)Gs (pooledhIgG). METHODS We studied the effects of IgGs purified from patients with SSc (SScIgGs) on cholinergic nerve stimulation in rat colon tissues. We also examined the effects of SScIgGs on M3-R activation by bethanechol (BeCh), M3-R occupancy, and receptor binding using mmunofluorescence, immunoblot, and ELISA analyses of human internal anal sphincter (IAS) smooth muscle cells (hSMCs), before and after administration of pooledhIgG. Functional displacement of M3-R occupancy by the SScIgGs was compared with that of other IgGs during the sustained phase of BeCh-induced contraction of intact smooth muscles from rats. RESULTS SScIgG significantly attenuated neutrally mediated contraction and acetylcholine release in rat colon as well as BeCh-induced sustained contraction of the IAS smooth muscle. In immunofluorescence analysis, SScIgG co-localized with M3-R. In immunoblot and ELISA analyses, M3-R loop-2 peptide and human IAS SMC membrane lysates bound significant amounts of SScIgG, compared with IgGs from healthy individuals and pooledhIgG. Binding was significantly attenuated by application of pooledhIgG, which by itself had no significant effect. Incubation of samples with pooledhIgG, or mixing pooledhIgG with SScIgG before administration to tissues, significantly reduced binding of SScIgG, indicating that pooledhIgG prevents SScIgG blockade of M3-R. CONCLUSIONS In studies of rat and human tissues, pooled human IgGs prevent and reverse the cholinergic dysfunctions associated with the progressive gastrointestinal manifestations of SSc, by neutralizing functional M3-R antibodies present in the circulation of patients with SSc. PMID:22864255

  4. Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis.

    PubMed

    Dostalik, Jan; Gunkova, Petra; Gunka, Igor; Mazur, Miloslav; Mrazek, Tomas

    2014-06-01

    Although natural orifice specimen extraction is now relatively widely performed, there have been no reports on gastric resection with specimen extraction through the transgastric route for peptic ulcer disease. A hybrid technique of the laparoscopic and endoscopic approach is presented in the case of a 58-year old male patient. Preoperative gastric fibroscopy showed postulcer pyloric and antral stenosis. Laparoscopic exploration confirmed gastric enlargement. Laparoscopic two-thirds gastrectomy was performed. The staple line suture of the residual stomach was excised and the specimen was extracted through the esophagus and mouth with a gastroscope. Finally, the residual stomach was closed again using linear endostaplers. Reconstruction was performed according to the Roux-en-Y method. Gastric resection using natural orifice specimen extraction (NOSE) may be a feasible operative procedure. The NOSE with the combination of standard laparoscopy and specimen extraction through a natural orifice can be considered as a bridge to natural orifice translumenal endoscopic surgery. PMID:25097701

  5. Temperature Sensitivity of the Pyloric Neuromuscular System and Its Modulation by Dopamine

    PubMed Central

    Thuma, Jeffrey B.; Hobbs, Kevin H.; Burstein, Helaine J.; Seiter, Natasha S.; Hooper, Scott L.

    2013-01-01

    We report here the effects of temperature on the p1 neuromuscular system of the stomatogastric system of the lobster (Panulirus interruptus). Muscle force generation, in response to both the spontaneously rhythmic in vitro pyloric network neural activity and direct, controlled motor nerve stimulation, dramatically decreased as temperature increased, sufficiently that stomach movements would very unlikely be maintained at warm temperatures. However, animals fed in warm tanks showed statistically identical food digestion to those in cold tanks. Applying dopamine, a circulating hormone in crustacea, increased muscle force production at all temperatures and abolished neuromuscular system temperature dependence. Modulation may thus exist not only to increase the diversity of produced behaviors, but also to maintain individual behaviors when environmental conditions (such as temperature) vary. PMID:23840789

  6. Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis

    PubMed Central

    Dostalik, Jan; Gunkova, Petra; Mazur, Miloslav; Mrazek, Tomas

    2014-01-01

    Although natural orifice specimen extraction is now relatively widely performed, there have been no reports on gastric resection with specimen extraction through the transgastric route for peptic ulcer disease. A hybrid technique of the laparoscopic and endoscopic approach is presented in the case of a 58-year old male patient. Preoperative gastric fibroscopy showed postulcer pyloric and antral stenosis. Laparoscopic exploration confirmed gastric enlargement. Laparoscopic two-thirds gastrectomy was performed. The staple line suture of the residual stomach was excised and the specimen was extracted through the esophagus and mouth with a gastroscope. Finally, the residual stomach was closed again using linear endostaplers. Reconstruction was performed according to the Roux-en-Y method. Gastric resection using natural orifice specimen extraction (NOSE) may be a feasible operative procedure. The NOSE with the combination of standard laparoscopy and specimen extraction through a natural orifice can be considered as a bridge to natural orifice translumenal endoscopic surgery. PMID:25097701

  7. Neural control of the posterior cardiac plate and pyloric regions of the mantis shrimp Squilla oratoria: neurogenic and myogenic activities of muscles

    Microsoft Academic Search

    Kenro Tazaki; Tohkichi Miyazaki

    1991-01-01

    Summary  \\u000a1. \\u000aMuscles of the posterior cardiac plate (pcp) and pyloric regions in the stomach of Squilla are innervated by motoneurons located in the stomatogastric ganglion (STG). The pattern of innervation of various muscles in these regions was determined using electrophysiological methods.\\u000a2. \\u000aThe dilator muscles are singly or doubly innervated by the pyloric dilator neurons (PDs). The constrictor muscles

  8. Biomechanical modeling of the rectum for the design of a novel artificial anal sphincter.

    PubMed

    Zan, Peng; Yan, Guozheng; Liu, Hua; Yang, Banghua; Zhao, Yujuan; Luo, Nianting

    2010-01-01

    This paper discusses biomechanical issues that are related to the option of a novel artificial anal sphincter around the human rectum. The prosthesis consists of a compression cuff system inside and a reservoir cuff system outside, which is placed around the debilitated sphincter muscle. The micropump shifts fluid between the cuffs and thus takes over the expansion and compression function of the sphincter muscle. However, the human rectum is not a rigid pipe, and motion in it is further complicated by the fact that the bowel is susceptible to damage. With the goal of engineering a safe and reliable machine, the biomechanical properties of the in-vivo porcine rectum are studied and the tissue ischemia is analyzed. PMID:20715360

  9. Immediate effects of the endoscopic sphincterotomy on the motility of the sphincter of Oddi.

    PubMed

    Romanello, L M; de Oliveira, R B; Brunaldi, J E; Costa-Pereira, L C; Módena, J L

    1988-01-01

    An endoscopic manometric technique was used to determine the CBD-duodenum junction pressure profile before and immediately after endoscopic sphincterotomy in 13 patients with common bile duct stones. Premedication (meperidine, atropine, and diazepam) was given to all patients and endoscopic retrograde cholangiopancreatography was performed before endoscopic sphincterotomy. In the patients with intact papilla the features of the sphincter of Oddi motility were similar to those previously described for patients not given premedication or submitted to cholangiography before endoscopic sphincterotomy. Endoscopic sphincterotomy which was successful for immediate stone removal in 9 of 13 patients caused an immediate reduction of sphincter of Oddi motility in all patients, but abolished it in only 2 of them. The present results show that successful common bile duct stone extraction by means of endoscopic sphincterotomy can be accomplished without total abolition of sphincter of Oddi motility. PMID:3268075

  10. The magnetic anal sphincter: a new device in the management of severe fecal incontinence.

    PubMed

    Mantoo, Surendra; Meurette, Guillaume; Podevin, Juliette; Lehur, Paul-Antoine

    2012-09-01

    The authors aim to report the concept and technique of implantation and the first results of the clinical use of the magnetic anal sphincter (MAS) in the management of fecal incontinence (FI). The MAS device is designed to augment the native anal sphincter. The implant is a series of titanium beads with magnetic cores linked together with independent titanium wires. To defecate, the force generated by straining separates the beads to open up the anal canal. The technique of implantation is simple with no requirement of adjustments. The MAS has a role in the management of severe FI. The device has acceptable and comparable adverse effects to other therapies. FI and Fecal Incontinence Quality of Life scores are significantly improved in the short term. The MAS offers a simple and less invasive option of anal reinforcement. It is one step further in the quest for an ideal artificial anal sphincter device. PMID:23116075

  11. EGJ Dysfunction and GERD

    Microsoft Academic Search

    P. J. Kahrilas; J. E. Pandolfino

    Theories of the mechanism of gastroesophageal junction competence have seesawed between strictly anatomic explanations, focusing\\u000a on type-I hiatus hernia, and physiologic explanations focusing on the vigor of LES contraction while ignoring the significance\\u000a of anatomic factors. As detailed above, current thinking recognizes contributions from both sphincteric components. Furthermore,\\u000a there is an increasing understanding of mechanical elements of the antireflux barrier,

  12. Comparative anti-ulcerogenic study of pantoprazole formulation with and without sodium bicarbonate buffer on pyloric ligated rat

    PubMed Central

    Bigoniya, Papiya; Shukla, A.; Singh, C. S.; Gotiya, P.

    2011-01-01

    Objective: To compare the anti-ulcer activity of buffered pantoprazole tablet against plain pantoprazole in pyloric ligated rats. Materials and Methods: In vivo pyloric ligated ulcerogenesis model was used to assess the effect of buffered pantoprazole on the volume of the gastric content, pH, total and free acidity, and ulcerogenic lesion. Pantoprazole level in gastric content and concurrently in stomach tissue was assessed by High Performance Liquid Chromatography (HPLC) analysis. Results: Buffered tablet effectively increases the pH of the gastric content above 4 up to 6 h (P<0.001) protecting pantoprazole from acid degradation resulting in high concentration in the gastric content and stomach tissue. Conclusions: This study substantiates better, faster and prolonged bioavailability of pantoprazole-buffered tablet compared to plain pantoprazole. PMID:21897712

  13. Eustachian Tube Dysfunction

    MedlinePLUS

    MENU Return to Web version Eustachian Tube Dysfunction Overview What is eustachian tube dysfunction? The eustachian tubes are small passageways that connect the upper part of your throat (pharynx) ...

  14. Comparison of Cystographic Findings of Intrinsic Sphincteric Deficiency with Urethral Hypermobility Causing Urinary Incontinence

    Microsoft Academic Search

    Sang Woo Park; Deuk Jae Sung; Eun Jung Choi; Min Woo Lee; Young Jun Kim; Jeong Geun Yi; Hae Jeong Jeon; Jeong Hee Park

    2007-01-01

    Objectives: To evaluate the usefulness of standing and lateral cystograms for differentiation of intrinsic sphincter deficiency (ISD) from urethral hypermobility (UH) causing stress urinary incontinence (SUI). Materials and Methods: 67 female patients with urinary incontinence undergoing measurement of the Valsalva leak point pressure (VLPP) were included. 14 patients with VLPP <60 cm H2O were operated for ISD causing SUI while

  15. Lower Esophageal Sphincter Reacts Against Intraabdominal Pressure in Children with Symptoms of Gastroesophageal Reflux

    Microsoft Academic Search

    Helena A. S. Goldani; MariaInez M. Fernandes; Yvone A. M. V. A. Vicente; Roberto O. Dantas

    2002-01-01

    Studies of the effect of increased intraabdominal pressure on the lower esophageal sphincter (LES) are controversial. This study aimed to verify the LES competence against extrinsic abdominal compression in children with and without symptoms of gastroesophageal reflux (GER). Eighteen children ages 6–20 months were evaluated, 11 of them with symptoms of GER (group I) and 7 without symptoms of GER

  16. Current Evaluation of Upper Oesophageal Sphincter Opening in Dysphagia Practice: An International SLT Survey

    ERIC Educational Resources Information Center

    Regan, Julie; Walshe, Margaret; McMahon, Barry P.

    2012-01-01

    Background: The assessment of adequate upper oesophageal sphincter (UOS) opening during swallowing is an integral component of dysphagia evaluation. Aims: To ascertain speech and language therapists' (SLTs) satisfaction with current methods for assessing UOS function in people with dysphagia and to identify challenges encountered by SLTs with UOS…

  17. Development of a Novel Artificial Urinary Sphincter: A Versatile Automated Device

    Microsoft Academic Search

    Hamid Lamraoui; Agnes Bonvilain; Gilberte Robain; Helene Combrisson; Skandar Basrour; Alexandre Moreau-Gaudry; Philippe Cinquin; Pierre Mozer

    2010-01-01

    Management of male severe stress urinary incontinence is currently achieved by the treatment of choice: an artificial urinary sphincter (AUS). This implantable system is designed to exert a constant circumferential force around the urethra. Although continence is totally or partially recovered in most of the patients, this method has some significant drawbacks. Besides the difficulty and discomfort of using the

  18. Assessing outcome after a modified vaginal wall sling for stress incontinence with intrinsic sphincter deficiency

    Microsoft Academic Search

    Elisabetta Costantini; Luigi Mearini; Ettore Mearini; Cinzia Pajoncini; Federico Guercini; Vittorio Bini; Massimo Porena

    2005-01-01

    Forty women with stress incontinence, intrinsic sphincter deficiency (ISD), associated or not with urethral hypermobility, a Valsalva leak point pressure (VLLP) 20 and a maximum urethral closure pressure 20 underwent in situ vaginal wall sling. The main modification to the technique was the use of two small Marlex meshes placed at the lateral edges of the sling. Outcome was assessed

  19. PUBOVAGINAL SLING USING CADAVERIC ALLOGRAFT FASCIA FOR THE TREATMENT OF INTRINSIC SPHINCTER DEFICIENCY

    Microsoft Academic Search

    E. JAMES WRIGHT; CHRISTOPHE E. ISELIN; LESLEY K. CARR; GEORGE D. WEBSTER

    1998-01-01

    PurposePubovaginal sling is the definitive management of female stress urinary incontinence due to intrinsic sphincter deficiency. Customarily, autologous fascia has been used, although synthetic material has its proponents. Harvesting autologous fascia at surgery is associated with postoperative discomfort, and synthetic material has a history of infection and erosion. To assess whether allograft fascia is free from these drawbacks, we retrospectively

  20. Effects of thienorphine on contraction of the guinea pig sphincter of Oddi, choledochus and gall bladder.

    PubMed

    Zhou, Peilan; Li, Tingting; Su, Ruibin; Gong, Zehui

    2014-08-15

    Opioid analgesics are widely believed to cause spasm of the bile duct sphincter and so impede bile flow. Thienorphine is a partial opioid agonist that is a good candidate for the treatment of opioid dependence; however, to date, no studies have reported the effects of thienorphine on the function of the biliary tract. This study examined the in vivo effects of thienorphine on the guinea pig isolated sphincter of Oddi, choledochus and gall bladder and on bile flow. The area under the curve (AUC) of isolated sphincter of Oddi was not influenced by thienorphine or buprenorphine, whereas morphine increased the AUC of the isolated sphincter of Oddi in a concentration-dependent manner. Thienorphine and buprenorphine concentration-dependently decreased the AUC of isolated choledochus, while morphine increased the AUC of isolated choledochus. Thienorphine had no effect on the contractile amplitude or basal tension of isolated gall bladder muscle strips. In contrast, buprenorphine and morphine increased the contractile basal tension of isolated gall bladder muscle strips in a concentration-dependent manner. Thienorphine (0.01-1.0mg/kg) had no significant inhibitory effect on bile flow. However, morphine (1.0-10mg/kg) and buprenorphine (1.0mg/kg) significantly inhibited bile flow. The maximum inhibition of bile flow by buprenorphine was 63.9±12.9% and by morphine was 74.1±11.3%. In summary, thienorphine has little influence on the guinea pig isolated sphincter of Oddi, choledochus and gall bladder or on bile flow, which may result in a lack of adverse biliary colic effects. PMID:24830319

  1. A missing sphincteric component of the gastro-oesophageal junction in patients with GORD.

    PubMed

    Miller, L; Dai, Q; Vegesna, A; Korimilli, A; Ulerich, R; Schiffner, B; Brassuer, J

    2009-08-01

    It was recently shown that the tonic pressure contribution to the high-pressure zone of the oesophago-gastric segment (OGS) contains the contributions from three distinct components, two of which are smooth muscle intrinsic sphincter components, a proximal and a distal component [J Physiol 2007; 580.3: 961]. The aim of this study was to compare the pressure contributions from the three sphincteric components in normal subjects with those in gastro-oesophageal reflux disease (GORD) patients. A simultaneous endoluminal ultrasound and manometry catheter was pulled through the OGS in 15 healthy volunteers and seven patients with symptomatic GORD, before and after administration of atropine. Pre-atropine (complete muscle tone), postatropine (non-muscarinic muscle tone plus residual muscarinic tone) and subtracted (pure muscarinic muscle tone) pressure contributions to the sphincter were averaged after referencing spatially to the right crural diaphragm and the pull-through start position. In the normal group, the atropine-resistant and atropine-attenuated pressures identified the crural and two smooth muscle sphincteric components respectively. The subtraction pressure curve contained proximal and distal peaks. The proximal component moved with the crural sling between full inspiration and full expiration and the distal component coincided with the gastric sling-clasp fibre muscle complex. The subtraction curve in the GORD patients contained only a single pressure peak that moved with the crural sphincter, while the distal pressure peak of the intrinsic muscle component, which was previously recognized in the normal subjects, was absent. We hypothesize that the distal muscarinic smooth muscle pressure component (gastric sling/clasp muscle fibre component) is defective in GORD patients. PMID:19368661

  2. Biochemical evaluation of an artificial anal sphincter made from shape memory alloys.

    PubMed

    Liu, Hongjian; Luo, Yun; Higa, Masaru; Zhang, Xiumin; Saijo, Yoshifumi; Shiraishi, Yasuyuki; Sekine, Kazumitsu; Yambe, Tomoyuki

    2007-01-01

    Severe anal incontinence is a socially incapacitating disorder and a major unresolved clinical problem that has a considerable negative impact on quality of life. In this study, we developed a new artificial anal sphincter using shape memory alloys (SMAs) in order to improve the quality of life of such patients and evaluated the influence of this sphincter on blood serum chemistry in animal experiments. The artificial anal sphincter was driven by two Ti-Ni SMA actuators sandwiching the intestine and was implanted in three female goats. Blood was collected from the jugular vein on days 1 and 4; at weeks 1 and 2; and at months 1, 2, and 3, postoperatively. Biochemical parameters including total protein, albumin, total bilirubin, aspartate amino-transferase, blood urea nitrogen, creatinine, and C-reactive protein were examined. The time courses of total bilirubin and aspartate amino transferase of the three goats were within the baseline levels after 1 week of implantation and remained normal, demonstrating no liver function complications. The blood urea nitrogen and creatinine levels remained within the normal range, indicating no renal function complications. The total protein and albumin fluctuated within the normal range throughout the duration of this study. In these goats, it was also found that the level of C-reactive protein did not increase and that there was no stricture of the intestine where the artificial sphincter was attached. Our findings indicate that the artificial sphincter SMA demonstrated no adverse influence on blood serum chemistry and exhibited an effective system performance. PMID:18071852

  3. New objective measures to quantify stress urinary incontinence in a novel durable animal model of intrinsic sphincter deficiency.

    PubMed

    Rodríguez, Larissa V; Chen, Shinhong; Jack, Gregory S; de Almeida, Fernando; Lee, Kyo Won; Zhang, Rong

    2005-05-01

    Existing animal models of stress urinary incontinence (SUI) are limited because of the low rate of incontinence seen in the animals and to their relatively low durability. In addition, most methods described to measure incontinence are operator-dependent. The aim of this study was to develop a new durable animal model of SUI and establish objective measures to quantify SUI. We subjected female rats to transabdominal urethrolysis. At baseline and at 1, 4, 8, 12, and 24 wk after intervention, animals underwent cystometry and evaluation with abdominal leak point pressure (ALPP). Urethral resistance was evaluated by retrograde urethral perfusion pressure (RUPP). Tissues were obtained for histology and immunohistochemistry. Normal female rats had an average ALPP of 19.4 cmH2O and RUPP of 22.6 cmH2O at baseline. More than 93% of the animals had significantly decreased ALPP and RUPP after the procedure. The mean ALPP and RUPP decreased to 9.8 cmH2O and 11.2 cmH2O, respectively, by 1 wk after urethrolysis. These changes were maintained for up to 24 wk. Changes seen in urethral resistance and ALPP appear to be mediated by apoptosis, decreased neuronal mass, and smooth muscle atrophy. These results indicate that transabdominal urethrolysis is a reliable method of achieving durable decreased urethral resistance in a SUI model. RUPP and ALPP are objective and reproducible methods of assessing urethral resistance. Changes in continence and urethral resistance appear to be mediated by denervation and smooth muscle atrophy, which are seen in both elderly incontinent patients and in patients with intrinsic sphincter dysfunction. PMID:15650117

  4. Genome-wide linkage analysis in families with infantile hypertrophic pyloric stenosis indicates novel susceptibility loci.

    PubMed

    Svenningsson, Anna; Söderhäll, Cilla; Persson, Sofia; Lundberg, Fredrik; Luthman, Holger; Chung, Eddie; Gardiner, Mark; Kockum, Ingrid; Nordenskjöld, Agneta

    2012-02-01

    Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of upper gastrointestinal obstruction during infancy. A multifactorial background of the disease is well established. Multiple susceptibility loci including the neuronal nitric oxide synthase (NOS1) gene have previously been linked to IHPS, but contradictory results of linkage studies in different materials indicate genetic heterogeneity. To identify IHPS susceptibility loci, we conducted a genome-wide linkage analysis in 37 Swedish families. In regions where the Swedish material showed most evidence in favor of linkage, 31 additional British IHPS families were analyzed. Evidence in favor of significant linkage was observed in the Swedish material to two loci on chromosome 2q24 (non-parametric linkage (NPL) =3.77) and 7p21 (NPL=4.55). In addition, evidence of suggestive linkage was found to two loci on chromosome 6p21 (NPL=2.97) and 12q24 (NPL=2.63). Extending the material with British samples did not enhance the level of significance. Regions with linkage harbor interesting candidate genes, such as glucagon-like peptide-2 (GLP-2 encoded by the glucagon gene GCG), NOS1, motilin (MLN) and neuropeptide Y (NPY). The coding exons for GLP-2, and NPY were screened for mutations with negative results. In conclusion, we could confirm suggestive linkage to the region harboring the NOS1 gene and detected additional novel susceptibility loci for IHPS. PMID:22158425

  5. Spinal mechanisms contributing to urethral striated sphincter control during continence and micturition: "how good things might go bad".

    PubMed

    Shefchyk, Susan J

    2006-01-01

    The external urethral sphincter motoneurons in the sacral ventral horn control the striated external urethral sphincter muscles that circle the urethra. Activity in these motoneurons and muscle normally contribute to continence but during micturition, when urine must pass through the urethra, the motoneurons and striated muscle must be silenced. Following injury to descending pathways in the spinal cord, the ability to inhibit sphincter activity is disrupted or lost, resulting in bladder-sphincter dyssynergia and functional obstruction of the urethra during voiding. This chapter will first review the various reflex pathways and neuronal properties that contribute to continence, and which must be modulated during micturition in the spinal intact animal. A discussion about how the dyssynergia seen with spinal cord injury may be produced will then be presented. PMID:16198695

  6. Transurethral Implantation of Macroplastique® for the Treatment of Female Stress Urinary Incontinence Secondary to Urethral Sphincter Deficiency

    Microsoft Academic Search

    S. C. Radley; C. R. Chapple; I. C. Mitsogiannis; K. S. Glass

    2001-01-01

    Objective: To assess the results of transurethral implantation of Macroplastique® in women with stress incontinence secondary to urethral sphincter deficiency using subjective and objective outcome measures.Methods: A total of 60 women with genuine stress incontinence secondary to intrinsic urethral sphincter deficiency were treated with transurethral implantation of Macroplastique. The patients had undergone a mean of 1.9 (range 0–7) previous episodes

  7. Female sexual dysfunction.

    PubMed

    Wright, Jennifer J; O'Connor, Kim M

    2015-05-01

    Female sexual dysfunction is a common patient concern. After providing an overview regarding the various types of female sexual dysfunction, we will focus on history taking and treatment options for desire, arousal, orgasm, and pain disorders. Testosterone therapy and management of selective serotonin reuptake inhibitor-associated sexual dysfunction are reviewed. Treatments for atrophic vaginitis are appraised. Patient cases lead the discussion, providing the reader with clinically relevant information. PMID:25841603

  8. Distal median nerve dysfunction

    MedlinePLUS

    ... type of distal median nerve dysfunction is carpal tunnel syndrome . ... repetitive movements increase the chance of developing carpal tunnel entrapment. Conditions that affect connective tissue or cause ...

  9. Preoperative Chemoradiation Therapy and Anal Sphincter Preservation with Locally Advanced Rectal Adenocarcinoma

    Microsoft Academic Search

    Pedro Luna-Pérez; Saúl Rodríguez-Ramírez; Darío F. Rodriguez-Coria; Armando Fernández; Sonia Labastida; Alejandro Silva; Marvin J. López

    2001-01-01

    .   Preoperative irradiation has been used to produce tumor regression and allow complete resection of rectal cancer with a sphincter-saving\\u000a procedure. To evaluate the associated toxicity, the response in the primary tumor, and the postsurgical morbidity in a group\\u000a of patients with locally advanced rectal cancer treated with preoperative chemoradiation therapy and low anterior resection,\\u000a 120 patients were treated with

  10. Improvement of nitrergic relaxation by farnesol of the sphincter of Oddi from hypercholesterolaemic rabbits

    Microsoft Academic Search

    Zoltan Szilvassy; Reka Sari; Jozsef Nemeth; Istvan Nagy; Sandor Csati; Janos Lonovics

    1998-01-01

    Field stimulation relaxed the rabbit sphincter of Oddi muscle rings after incubation with atropine (1 ?M) and guanethidine (4 ?M) with a threefold increase in tissue cyclic cGMP content, a response previously shown to be essentially nitrergic. Preparations from hypercholesterolaemic rabbits (1.5% dietary cholesterol load over 8 weeks increasing serum total cholesterol from pre-diet 1.4±0.3 to 22.6±3.8 mmol\\/l) exhibited contractions

  11. The effect of sildenafil on lower esophageal sphincter and body motility in normal male adults

    Microsoft Academic Search

    Poong-Lyul Rhee; Jae Geun Hyun; Jun Haeng Lee; Young-Ho Kim; Hee Jung Son; Jae J Kim; Seung Woon Paik; Jong Chul Rhee; Kyoo Wan Choi

    2001-01-01

    OBJECTIVE:Sildenafil relaxes smooth muscle by blocking type 5 phosphodiesterase, which destroys nitric oxide-stimulated cyclic guanosine monophosphate. The aim of this study is to investigate the change of lower esophageal sphincter (LES) and body motility with the lapse of time after sildenafil infusion in normal male adults.METHODS:After basal esophageal manometry in eight healthy male adult volunteers, we infused a 50-mg tablet

  12. The Gore-tex sling procedure for female sphincteric incontinence: indications, technique, and results

    Microsoft Academic Search

    David R. Staskin; Jong M. Choe; David S. Breslin

    1997-01-01

    We constructed a pubovaginal sling using the Gore-tex Soft Tissue Patch and 2-0 polytetrafluoroethlene (PTFE) suspension suture and placed it in 122 consecutive incontinent women with urethral hypermobility and\\/or intrinsic sphincter deficiency. We performed a retrospective outcome analysis using a questionnaire-based telephone survey. The mean follow-up period was 24.4 months. Stress incontinence was cured in 88% of patients (equally effective

  13. Membrane hyperpolarization, cyclic nucleotide levels and relaxation in the guinea-pig internal anal sphincter.

    PubMed Central

    Baird, A. A.; Muir, T. C.

    1990-01-01

    1. Changes in membrane potential (measured with an intracellular microelectrode) and in cyclic nucleotide (adenosine 3':5'-cyclic monophosphate, cyclic AMP and guanosine 3':5'-cyclic monophosphate, cyclic GMP) levels (measured by radioimmunoassay) in response to inhibitory non-adrenergic non-cholinergic (NANC) field stimulation and drugs were investigated in the guinea-pig internal and anal sphincter (gpIAS) in the presence of phentolamine and atropine (each 10(-6) M). 2. Inhibitory NANC nerve stimulation (single pulse, 5 pulses at 5, 10 and 20 Hz, 0.5 ms supramaximal voltage) and adenosine triphosphate (ATP, 10(-7)-10(-3) M) inhibited spike discharge, hyperpolarized the membrane and relaxed the sphincter. The effects of inhibitory nerve stimulation were blocked by tetrodotoxin (TTX, 10(-6) M) and, with those of ATP, were blocked by apamin (5 x 10(-6) M). 3. Isoprenaline (10(-9)-10(-4) M), cromakalim (10(-9)-10(-5) M), sodium nitroprusside (NaNP 10(-5) M), M&B 22948 (10(-4) M) and 8-bromocyclic GMP (8-Br-cyclic GMP, 10(-4) M) also inhibited spike discharge, hyperpolarized the membrane and relaxed the sphincter. The effects of isoprenaline were blocked by propranolol (10(-6) M). However, forskolin (10(-9)-10(-7) M), M&B 22948 (10(-9)-10(-5) M) and lower concentrations of NaNP (10(-9)-10(-6) M) relaxed the sphincter without affecting the membrane potential. 4. The characteristics of the membrane potential changes in response to different inhibitory stimuli in the gpIAS differed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1974160

  14. Genetic evidence for the neuronal nitric oxide synthase gene (NOS1) as a susceptibility locus for infantile pyloric stenosis

    SciTech Connect

    Chung, E.; Chen, G.; Gardiner, M. [Rayne Inst., London (United Kingdom)] [and others

    1996-02-01

    The etiological role of the gene for neuronal nitric oxide synthase (NOS1) in infantile pyloric stenosis (PS) was investigated by analysis of two intragenic polymorphisms (NOS1a and NOS1b) in 27 families. There was significant overall transmission disequilibrium between PS and NOS1a (P=.006). Consideration of each allele independently revealed a highly significant tendency for allele 7 (210 bp) to be preferentially transmitted to the affected offspring (P=.0006). These observations suggest that NOS1 is a susceptibility locus for PS. 38 refs., 1 fig., 3 tabs.

  15. Similarities and differences in the epidemiology of pyloric stenosis and SIDS.

    PubMed

    Lisonkova, Sarka; Joseph, K S

    2014-09-01

    Similar temporal declines in infantile hypertrophic pyloric stenosis (IHPS) and sudden infant death syndrome (SIDS) and other common features have led to hypotheses about a shared etiology. We carried out a population-based study to highlight similarities and differences between IHPS and SIDS. We used vital statistics and hospitalization data on all live births in Washington State, USA (1987-2009). Changes in IHPS and SIDS rates over time were quantified using rate ratios with 95 % confidence intervals (CI). The duration between birth and diagnosis of IHPS or SIDS was examined as a function of gestational age at birth. Logistic regression analysis was used to identify risk factors and quantify adjusted temporal trends (2000-2008). Although both IHPS and SIDS rates declined significantly between 1987 and 2008, the patterns and magnitude of the declines (40 and 74 %, respectively) were different. IHPS and SIDS shared risk factors such as maternal smoking and single parent status but other factors showed qualitatively or and quantitatively different associations. Primiparity was a risk factor for IHPS [odds ratio (OR) 1.24, 95 % CI 1.09-1.41], and a protective factor for SIDS (OR 0.44, 95 % CI 0.36-0.55), while male sex had a stronger association with IHPS (OR 4.51, 95 % CI 3.85-5.28 vs 1.36, 95 % CI 1.13-1.64). Both IHPS and SIDS showed significant inverse associations between gestational age at birth and chronologic age at diagnosis/death. IHPS and SIDS share some epidemiologic features and risk factors but other risk factors have qualitatively or quantitatively different effects and recent temporal trends in the two diseases are dissimilar. PMID:24337864

  16. Differential Gene Expression in the Oxyntic and Pyloric Mucosa of the Young Pig

    PubMed Central

    Colombo, Michela; Priori, Davide; Trevisi, Paolo; Bosi, Paolo

    2014-01-01

    The stomach is often considered a single compartment, although morphological differences among specific areas are well known. Oxyntic mucosa (OXY) and pyloric mucosa (PYL, in other species called antral mucosa) are primarily equipped for acid secretion and gastrin production, respectively, while it is not yet clear how the remainder of genes expressed differs in these areas. Here, the differential gene expression between OXY and PYL mucosa was assessed in seven starter pigs. Total RNA expression was analyzed by whole genome Affymetrix Porcine Gene 1.1_ST array strips. Exploratory functional analysis of gene expression values was done by Gene Set Enrichment Analysis, comparing OXY and PYL. Normalized enrichment scores (NESs) were calculated for each gene (statistical significance defined when False Discovery Rate % <25 and P-values of NES<0.05). Expression values were selected for a set of 44 genes and the effect of point of gastric sample was tested by analysis of variance with the procedure for repeated measures. In OXY, HYDROGEN ION TRANSMEMBRANE TRANSPORTER ACTIVITY gene set was the most enriched set compared to PYL, including the two genes for H+/K+-ATPase. Pathways related to mitochondrial activity and feeding behavior were also enriched (primarily cholecystokinin receptors and ghrelin). Aquaporin 4 was the top-ranking gene. In PYL, two gene sets were enriched compared with OXY: LYMPHOCYTE ACTIVATION and LIPID RAFT, a gene set involved in cholesterol-rich microdomains of the plasma membrane. The single most differentially expressed genes were gastrin and secretoglobin 1A, member 1, presumably located in the epithelial line, to inactivate inflammatory mediators. Several genes related to mucosal integrity, immune response, detoxification and epithelium renewal were also enriched in PYL (P<0.05). The data indicate that there is significant differential gene expression between OXY of the young pig and PYL and further functional studies are needed to confirm their physiological importance. PMID:25357124

  17. Novel artificial anal sphincter system based on transcutaneous energy transmission system tested in vivo.

    PubMed

    Wang, Yongbing; Liu, Hua; Xu, Qianqian; Yan, Guozheng

    2013-12-01

    This paper proposes a novel artificial anal sphincter system (AASS) for severe fecal incontinence. The AASS is composed of an artificial anal sphincter (AAS), an external transcutaneous energy transmission system (TETS), and an external control device. The AAS is composed of a cuff, a micropump, a reservoir, and a remote control device. It is designed to be implanted into the body of the patient. The function of the AAS is to open and close the patient's natural anus. Patients suffering from loss of their natural sphincter lose rectal sensation and are thus unable to perceive imminent fecal incontinence. In order to restore rectal sensation, a pressure sensor in the AAS cuff is designed to detect pressure in the colon. The pressure reflects the present quantity of colon contents, allowing patients to control the AAS to open or close the anus according to the pressure. The TETS is designed to provide electrical energy to the implanted AAS without wire connections. The external control device is designed to receive the pressure information from the AAS and send the patient's command to the implanted device. This paper provides a thorough discussion of the design of the novel AASS and describes the performance of the AASS when tested in vivo on two Beagle dogs who were chosen to be the subjects for receiving the implant. The experimental results verified that the performance of the AASS met the functional requirements it was designed for; however, the trial also revealed some challenges to be further studied. PMID:24362899

  18. The dysfunctional foreskin.

    PubMed

    Porter, W M; Bunker, C B

    2001-04-01

    Although important, the foreskin is not absolutely essential to penile function. Dysfunction is common and a cause of considerable morbidity, and is sometimes associated with mortality from squamous cell carcinoma (SCC). Penile dermatoses herald, complicate or cause preputial dysfunction. Their effective diagnosis and management reduces morbidity and possibly mortality. Medical treatment has its limitations and circumcision is often required. PMID:11319970

  19. Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomised trial comparing short-term radiotherapy vs. conventionally fractionated radiochemotherapy

    Microsoft Academic Search

    K. Bujko; M. P. Nowacki; A. Nasierowska-Guttmejer; W. Michalski; M. B; M. Pude?ko; M. Kryj; J. Ol; J. Szmeja; J. S?uszniak; K. Serkies; J. K?adny; M. Pamucka; P. Kuko?owicz

    2004-01-01

    Background and purposeThe aim was to verify whether preoperative conventionally fractionated chemoradiation offers an advantage in sphincter preservation in comparison with preoperative short-term irradiation.

  20. The ontogeny of the peptide innervation of the human pylorus, with special reference to understanding the aetiology and pathogenesis of infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    Robin Michael Abel

    1996-01-01

    Pyoric stenosis (PS) is a common condition in infancy, which is associated with smooth muscle hypertrophy that results in pyloric outlet obstruction. The author examines the ontogeny of the peptide innervation of the pylorus in fetal tissues and an experimental model in mice and evaluates the histochemical and morphological changes in the pylorus. The data suggest that PS is an

  1. A study of 11,003 patients with hypertrophic pyloric stenosis and the association between surgeon and hospital volume and outcomes

    Microsoft Academic Search

    Shawn D. Safford; Ricardo Pietrobon; Kristine M. Safford; Henrique Martins; Michael A. Skinner; Henry E. Rice

    2005-01-01

    AimThe availability of large clinical databases allows for careful evaluation of surgical practices, indicators of quality improvement, and cost. We used a large clinical database to compare the effect of surgeon and hospital volume for the care of children with hypertrophic pyloric stenosis (HPS).

  2. Highly selective vagotomy plus dilatation of the stenosis compared with truncal vagotomy and drainage in the treatment of pyloric stenosis secondary to duodenal ulceration

    Microsoft Academic Search

    M J McMahon; M J Greenall; D Johnston; J C Goligher

    1976-01-01

    Twenty-three consecutive patients with duodenal ulceration complicated by pyloric stenosis who came under the care of one surgeon were treated by highly selective vagotomy (HSV) combined with digital dilatation of the stenosis through a gastrotomy. No form of drainage procedure was used. Thus the antral \\

  3. Physiological attributes of the pyloric caeca and anterior intestine of green sunfish ( Lepomis cyanellus) potentially influencing microhabitat specificity of Leptorhynchoides thecatus (Acanthocephala)

    Microsoft Academic Search

    Dennis J. Richardson; Brent B. Nickol

    1999-01-01

    Pyloric caeca are present in some species of fish and serve as a habitat for many helminth parasites. Physiological and biochemical attributes of luminal contents of the caeca and proximal intestine of green sunfish, Lepomis cyanellus, were compared to determine factors that could account for localization of Leptorhynchoides thecatus (Acanthocephala) in caeca after initial establishment in caeca and anterior portion

  4. Temporomandibular Joint Dysfunction

    MedlinePLUS

    The temporomandibular joint (TMJ) connects your jaw to the side of your head. When it works well, it enables you to ... For people with TMJ dysfunction, problems with the joint and muscles around it may cause Pain that ...

  5. Resolving sphincter of Oddi incontinence for primary duodenal Crohn's disease with strictureplasty

    PubMed Central

    Alemanno, G.; Sturiale, A.; Bellucci, F.; Giudici, F.; Tonelli, F.

    2012-01-01

    INTRODUCTION Crohn's involvement of duodenum is a rare event and may be associated to proteiform symptoms and uncommon pathological aspects which make diagnosis and treatment complex. PRESENTATION OF CASE The peculiar aspect of this case was a suspected duodeno-biliary fistula. The patient (female, 22 years old) was affected by duodenal Crohn's disease. Magnetic resonance imaging showed a dilated common bile duct, whose final part linked to a formation containing fluid, and characterized by filling of the contrast medium in the excretory phase. Abdominal ultrasound showed intra-hepatic and intra-gallbladder aerobilia. At surgery, the duodenum was mobilized showing an inflammatory stricture and a slight dilatation of the common bile duct, with no signs of fistulas. The opened duodenum was anastomized side to side to a transmesocolic loop of the jejunum. After surgery, the general condition of the patient improved. DISCUSSION Only two cases of fistula between a narrow duodenal bulb and the common bile duct have been described in literature and the Authors were not be able to verify the occurrence of a duodenal biliary fistula at surgery. The association between duodenal Crohn's disease and Sphincter of Oddi incontinence is a very rare finding with different etiology: chronic intestinal pseudo-obstruction, common bile duct stones, progressive systemic sclerosis. CONCLUSION The treatment to resolve Sphincter of Oddi incontinence for primary duodenal Crohn's disease is not clear. Strictureplasty could be the treatment of choice, because, resolving the stricture, the duodenal pressure is likely to decrease and the reflux through the incontinent sphincter can be avoided. PMID:23276753

  6. [Simultaneous registration of rheographic and manometric parameters of the inferior esophageal sphincter in the cat].

    PubMed

    Di Lorenzo, M; Giannazzo, E; Giuffrida, R; Sapienza, S

    1985-03-30

    The aim of the present study was to detect simultaneously hemodynamic parietal events and intraluminal pressure of the Lower Esophageal Sphincter (LES), with particular regards to cyclic changes due to systo-diastolic cardiac activity. A probe for combined Intraluminal Manometric Plethysmography (IMP) and Intraluminal Impedence Plethysmography (IIP) was used. It was a Swan Ganz bipolar pacing catheter, modified by removing the latex balloon from the tip. The exposed side-hole (diameter smaller than 0.5 mm) was utilized as a terminal orifice for an infused manometry system. It was preliminarly essayed in bench tests. A perfusion rate of 1.75 ml/min was chosen as it did not induce significant elevations of the pressure base-line and allowed detection of pressure rise rates up to 300 mm Hg/s. The two metallic rings, originally designed for intracardiac stimulation, were used as low resistance electrodes to record impedence variations. Since very small shifts of recording electrodes induce important artifacts, the present experiments were carried out on curarized cats. In these conditions, artificial ventilation could be temporarily stopped to avoid any artifact due to respiration mechanics. The proposed method seems to be satisfactory enough for simultaneous acquisition of IIP and IMP data at LES level. Recordings of IIP allow to reveal changes in parietal blood content which could chiefly be referred to lamina propria and submucosa districts. On the other hand, IMP cyclic fluctuations would signal variations of total sphincteric tension, likely depending on hemodynamic events in all vascular beds of the wall. In our opinion, a more extensive analysis of IMP and IIP waves, as well as of reciprocal relationships between rheografic and manometric parameters, may provide very useful knowledges on sphincteric physiology. PMID:4027028

  7. Assessment of endothelial dysfunction.

    PubMed

    Freestone, Bethan; Krishnamoorthy, Suresh; Lip, Gregory Y H

    2010-04-01

    The pathophysiology underlying the initiation and progression of cardiovascular disorders is highly complex and multifactorial. The endothelium also plays a crucial role in the pathogenesis of thrombogenesis and atherogenesis, and a continuum of endothelial activation, dysfunction or damage is evident in many cardiovascular disorders both at the macro and microscopic level(s). This review article aims to provide an overview of the assessment of endothelial (dys)function and discuss the implications and limitations of such assessments. PMID:20397829

  8. A comparison of common bile duct pressures after botulinum toxin injection into the sphincter of Oddi versus biliary stenting in a canine model

    Microsoft Academic Search

    Jeffrey M Marks; Andrew L Bower; Marlene Goormastic; Janis L Malycky; Jeffrey L Ponsky

    2001-01-01

    Background: Botulinum toxin A (Botox) functionally paralyzes the sphincter of Oddi in both animals and humans, resulting in reduced pressures. No study, however, has specifically addressed common bile duct (CBD) pressures after Botox injection into the sphincter of Oddi with regard to treating biliary leaks and fistulae. The goals of this present study are to compare, versus biliary stenting, the

  9. Effects of botulinum toxin A on the sphincter of Oddi: an in vivo and in vitro study

    PubMed Central

    Sand, J; Nordback, I; Arvola, P; Porsti, I; Kalloo, A; Pasricha, P

    1998-01-01

    Background—Botulinum toxin A is a potent inhibitor of the release of acetylcholine from nerve endings. Local injection of botulinum toxin has recently been suggested to be helpful in sphincter of Oddi dyskinesia by decreasing sphincter of Oddi pressure. ?Aims—To explore the mechanism of action of botulinum toxin A on sphincter of Oddi (SO) muscle. ?Methods—Four piglets underwent duodenoscopy and SO manometry was performed. After obtaining a baseline pressure, the SO was injected with normal saline and the experiment repeated after one week. The SO was then injected endoscopically with botulinum toxin (40 U) with follow up manometry one week later. The sphincter of Oddi was removed from 10 pigs, cut into three rings, and placed in an organ bath. The force of contraction was measured and registered on a polygraph. Rings were stimulated by 70 V (10 Hz, 0.5 ms) electrical field stimulation for 20 seconds, exogenous acetylcholine (100 µM), and KCl (125 mM). Botulinum toxin (0.1 U/ml) or atropine (1 µM) was added to the incubation medium and the stimulation was repeated. ?Results—Mean basal SO pressure in the pigs remained unchanged after saline injection but decreased to about 50% of baseline value following botulinum toxin injection (p=0.04). The contractions induced by direct stimulation of SO smooth muscle with KCl were not significantly affected by either atropine or botulinum toxin. In all rings exogenous acetylcholine induced contractions, which were totally blocked by atropine, but not by botulinum toxin. Electrical field stimulation induced contractions that were inhibited by both atropine and botulinum toxin. ?Conclusion—Botulinum toxin inhibits pig sphincter of Oddi smooth muscle contractions by a presynaptic cholinergic mechanism, similar to that described in skeletal muscle. ?? Keywords: sphincter of Oddi; botulinum toxin; pig; ex vivo PMID:9616312

  10. Antiulcerogenic potential of Strychnos potatorum Linn seeds on aspirin plus pyloric ligation-induced ulcers in experimental rats.

    PubMed

    Sanmugapriya, E; Venkataraman, S

    2007-05-01

    Strychnos potatorum (Fam: Loganiaceae) Linn seeds are useful in the treatment of gastropathy in Indian traditional system of medicine. The present study describes the antiulcerogenic potential of S. potatorum Linn seeds on aspirin plus pyloric ligation (Aspirin+PL)-induced gastric ulcer model to substantiate its folklore claim. The seed powder (SPP) and aqueous extract of the seeds (SPE) at two doses 100 and 200 mg/kg, p.o. prevented ulcer formation by decreasing acid secretory activity and increasing the mucin activity in rats. The antiulcerogenic potential was further confirmed by the histopathological studies of stomach mucosa. The results indicate that SPP and SPE exhibit antiulcerogenic activity by both antisecretory and mucoprotective actions. The mucoprotective action of SPP and SPE may be due to the presence of polysaccharides in seeds. The antiulcerogenic potential of SPP and SPE was compared with the standard antiulcer drug, ranitidine. PMID:17317130

  11. Linkage of Monogenic Infantile Hypertrophic Pyloric Stenosis to Chromosome 16p12-p13 and Evidence for Genetic Heterogeneity

    PubMed Central

    Capon, Francesca; Reece, Ashley; Ravindrarajah, Rathi; Chung, Eddie

    2006-01-01

    Infantile hypertrophic pyloric stenosis (IHPS) is the most common form of bowel obstruction in infancy. The disease affects males four times more often than females and is considered a paradigm for the sex-modified model of multifactorial inheritance. However, pedigrees consistent with autosomal dominant inheritance have also been documented. We analyzed a 3-generation family with IHPS including 10 affected individuals (5 males and 5 females) and mapped the underlying disease locus to chromosome 16p12-p13 (LOD score 3.23) by using a single-nucleotide polymorphism–based genomewide scan. The analysis of 10 additional multiplex pedigrees yielded negative or nonsignificant LOD scores, indicating the presence of locus heterogeneity. Sequence analysis of candidate genes from the chromosome 16 disease interval excluded the presence of pathogenic mutations in the GRIN2A and MYH11 genes. PMID:16826529

  12. Nerve mediated relaxation of the human internal anal sphincter: the role of nitric oxide.

    PubMed

    O'Kelly, T; Brading, A; Mortensen, N

    1993-05-01

    The aim of this study was to determine if nitric oxide (NO) is the non-adrenergic, non-cholinergic neurotransmitter, released by enteric inhibitory nerves, which mediates relaxation of the human internal anal sphincter. Isolated muscle strips were mounted for isometric tension recording in superfusion organ baths. Sodium nitroprusside, an exogenous donor of NO, relaxed the strips in a concentration dependent manner. In the presence of atropine and guanethidine, transmural field stimulation produced tetrodotoxin sensitive relaxations, which were inhibited in a dose dependent and enantiomer specific manner by antagonists of NO synthase; completely by L-nitroarginine and partially by L-N-monomethyl arginine. The effect of these antagonists was reversed by L-arginine but not D-arginine. Oxyhaemoglobin, a scavenger of nitric oxide, also abolished the relaxations but methaemoglobin had no such effect. These results strongly suggest that NO is, or is very closely associated with, the non-adrenergic, non-cholinergic neurotransmitter mediating neurogenic relaxation of the human internal anal sphincter. PMID:7684992

  13. Safety analysis of first 1000 patients treated with magnetic sphincter augmentation for gastroesophageal reflux disease.

    PubMed

    Lipham, J C; Taiganides, P A; Louie, B E; Ganz, R A; DeMeester, T R

    2015-05-01

    Antireflux surgery with a magnetic sphincter augmentation device (MSAD) restores the competency of the lower esophageal sphincter with a device rather than a tissue fundoplication. As a regulated device, safety information from the published clinical literature can be supplemented by tracking under the Safe Medical Devices Act. The aim of this study was to examine the safety profile of the MSAD in the first 1000 implanted patients. We compiled safety data from all available sources as of July 1, 2013. The analysis included intra/perioperative complications, hospital readmissions, procedure-related interventions, reoperations, and device malfunctions leading to injury or inability to complete the procedure. Over 1000 patients worldwide have been implanted with the MSAD at 82 institutions with median implant duration of 274 days. Event rates were 0.1% intra/perioperative complications, 1.3% hospital readmissions, 5.6% endoscopic dilations, and 3.4% reoperations. All reoperations were performed non-emergently for device removal, with no complications or conversion to laparotomy. The primary reason for device removal was dysphagia. No device migrations or malfunctions were reported. Erosion of the device occurred in one patient (0.1%). The safety analysis of the first 1000 patients treated with MSAD for gastroesophageal reflux disease confirms the safety of this device and the implantation technique. The overall event rates were low based on data from 82 institutions. The MSAD is a safe therapeutic option for patients with chronic, uncomplicated gastroesophageal reflux disease. PMID:24612509

  14. Automatic detection of motor unit innervation zones of the external anal sphincter by multichannel surface EMG.

    PubMed

    Ullah, Khalil; Cescon, Corrado; Afsharipour, Babak; Merletti, Roberto

    2014-12-01

    A method to detect automatically the location of innervation zones (IZs) from 16-channel surface EMG (sEMG) recordings from the external anal sphincter (EAS) muscle is presented in order to guide episiotomy during child delivery. The new algorithm (2DCorr) is applied to individual motor unit action potential (MUAP) templates and is based on bidimensional cross correlation between the interpolated image of each MUAP template and two images obtained by flipping upside-down (around a horizontal axis) and left-right (around a vertical axis) the original one. The method was tested on 640 simulated MUAP templates of the sphincter muscle and compared with previously developed algorithms (Radon Transform, RT; Template Match, TM). Experimental signals were detected from the EAS of 150 subjects using an intra-anal probe with 16 equally spaced circumferential electrodes. The results of the three algorithms were compared with the actual IZ location (simulated signal) and with IZ location provided by visual analysis (VA) (experimental signals). For simulated signals, the inter quartile error range (IQR) between the estimated and the actual locations of the IZ was 0.20, 0.23, 0.42, and 2.32 interelectrode distances (IED) for the VA, 2DCorr, RT and TM methods respectively. PMID:24948528

  15. Olfactory dysfunction in dementia

    PubMed Central

    Alves, Jorge; Petrosyan, Agavni; Magalhães, Rosana

    2014-01-01

    The natural aging process brings about some inevitable consequences, such as olfactory dysfunction, which is also frequently linked to numerous neurodegenerative disorders. Many age-related dementia, such as Alzheimer’s disease, Vascular dementia, Parkinson’s disease, and Frontotemporal Dementia often display olfactory dysfunction. Despite the overwhelming evidence of above mentioned facts, the symptomatic relevance and potential clinical and pre-clinical value of olfactory dysfunction remains overlooked by many clinicians and public alike. Olfactory dysfunction has strong practical implications on daily activities and, although not as prominent as in other mammals, olfaction is still an evolutionarily relevant sense involved in human survival (e.g., smelling gas; bad food). In this work, we provide a brief review of current research related to the olfactory dysfunction profiles in different types of dementia. Additionally, we present a compilation of accessible, easy to use olfaction assessment tools; and highlight future directions in terms of improving clinical diagnosis in patient care and research. PMID:25405189

  16. Endothelial dysfunction in diabetes

    PubMed Central

    De Vriese, An S; Verbeuren, Tony J; Van de Voorde, Johan; Lameire, Norbert H; Vanhoutte, Paul M

    2000-01-01

    Endothelial dysfunction plays a key role in the pathogenesis of diabetic vascular disease. The endothelium controls the tone of the underlying vascular smooth muscle through the production of vasodilator mediators. The endothelium-derived relaxing factors (EDRF) comprise nitric oxide (NO), prostacyclin, and a still elusive endothelium-derived hyperpolarizing factor (EDHF). Impaired endothelium-dependent vasodilation has been demonstrated in various vascular beds of different animal models of diabetes and in humans with type 1 and 2 diabetes. Several mechanisms of endothelial dysfunction have been reported, including impaired signal transduction or substrate availibility, impaired release of EDRF, increased destruction of EDRF, enhanced release of endothelium-derived constricting factors and decreased sensitivity of the vascular smooth muscle to EDRF. The principal mediators of hyperglycaemia-induced endothelial dysfunction may be activation of protein kinase C, increased activity of the polyol pathway, non-enzymatic glycation and oxidative stress. Correction of these pathways, as well as administration of ACE inhibitors and folate, has been shown to improve endothelium-dependent vasodilation in diabetes. Since the mechanisms of endothelial dysfunction appear to differ according to the diabetic model and the vascular bed under study, it is important to select clinically relevant models for future research of endothelial dysfunction. PMID:10882379

  17. Immune dysfunction in cirrhosis

    PubMed Central

    Sipeki, Nora; Antal-Szalmas, Peter; Lakatos, Peter L; Papp, Maria

    2014-01-01

    Innate and adaptive immune dysfunction, also referred to as cirrhosis-associated immune dysfunction syndrome, is a major component of cirrhosis, and plays a pivotal role in the pathogenesis of both the acute and chronic worsening of liver function. During the evolution of the disease, acute decompensation events associated with organ failure(s), so-called acute-on chronic liver failure, and chronic decompensation with progression of liver fibrosis and also development of disease specific complications, comprise distinct clinical entities with different immunopathology mechanisms. Enhanced bacterial translocation associated with systemic endotoxemia and increased occurrence of systemic bacterial infections have substantial impacts on both clinical situations. Acute and chronic exposure to bacteria and/or their products, however, can result in variable clinical consequences. The immune status of patients is not constant during the illness; consequently, alterations of the balance between pro- and anti-inflammatory processes result in very different dynamic courses. In this review we give a detailed overview of acquired immune dysfunction and its consequences for cirrhosis. We demonstrate the substantial influence of inherited innate immune dysfunction on acute and chronic inflammatory processes in cirrhosis caused by the pre-existing acquired immune dysfunction with limited compensatory mechanisms. Moreover, we highlight the current facts and future perspectives of how the assessment of immune dysfunction can assist clinicians in everyday practical decision-making when establishing treatment and care strategies for the patients with end-stage liver disease. Early and efficient recognition of inappropriate performance of the immune system is essential for overcoming complications, delaying progression and reducing mortality. PMID:24627592

  18. Anterior anal sphincter repair can be of long term benefit: a 12-year case cohort from a single surgeon

    PubMed Central

    Grey, Benjamin R; Sheldon, Rowena R; Telford, Karen J; Kiff, Edward S

    2007-01-01

    Background Early surgical results of anterior sphincter repair for faecal incontinence can be good, but in the longer term are often disappointing. This study aimed to determine the short and long term outcomes from anterior sphincter repair and identify factors predictive of long term success. Methods Patients who underwent anterior sphincter repair between 1989 and 2001 in one institution were identified. Postal questionnaires were sent to patients, which included validated scoring systems for symptom severity and quality of life assessments for faecal incontinence. Patient demographics and risk factors were recorded as were the results of anorectal physiology studies and endoanal ultrasound. Results Eighty-five patients underwent repair by one consultant. The length of follow up ranged from 1 to 12 years. Most patients (96%) had early symptom improvement postoperatively. Of the 47 patients assessed long term (? 5 years), 28 (60%) maintained this success. Significant improvements in quality of life were observed (P < 0.001). Neither patient, surgical nor anorectal physiology study parameters were predictive of outcome. Conclusion There were no predictive factors of outcome success and no changes in anal manometry identified, however anterior sphincter repair remains worthwhile. Changes in compliance of the anorectum may be responsible for symptom improvement. PMID:17217528

  19. Dysfunction Travel-associated

    E-print Network

    Steve Kemp

    Multiorgan Dysfunction Caused by Travel-associated African Trypanosomiasis Lucy E. Cottle, Joanna RMED-mail in persons who had traveled to this region. Trypanosomiasis remains rare in travelers but should be considered in febrile patients who have returned from trypanosomiasis-endemic areas of Africa. We describe

  20. Sexual Dysfunction in Women

    MedlinePLUS

    ... to 70% of couples have a problem with sex at some time in their relationships. Most women will have sex that doesn't feel good at some point ... that my problems will cause tension in my relationship. What should I do? Is it safe for me to have sex? Can I get pregnant? Source Female Sexual Dysfunction: ...

  1. Function of posterior HoxD genes in the morphogenesis of the anal sphincter.

    PubMed

    Kondo, T; Dollé, P; Zákány, J; Duboule, D

    1996-09-01

    Vertebrate 5'-located HoxD genes are expressed in the most caudal part of the digestive tract and their potential functions during gut development have been assessed by gene disruptions. We have inserted reporter lacZ sequences within the Hoxd-12 gene and analysed the morphology of the gut in these mice as well as in Hoxd-13 mutant animals. When homozygous, both mutations induce an important disorganization of the anorectal region. In particular, severe alterations of the smooth muscle layers of the rectum led to defective morphogenesis of the internal anal sphincter. Similarly, Hoxd-12 and Hoxd-13 functionally overlap during digit development. The function of these genes in the morphogenesis of the digestive system as well as their functional evolution are discussed. PMID:8787740

  2. Mitochondrial dysfunction in neurodegenerative diseases

    Microsoft Academic Search

    M. Flint Beal

    1998-01-01

    A potential pivotal role for mitochondrial dysfunction in neurodegenerative diseases is gaining increasing acceptance. Mitochondrial dysfunction leads to a number of deleterious consequences including impaired calcium buffering, generation of free radicals, activation of the mitochondrial permeability transition and secondary excitotoxicity. Neurodegenerative diseases of widely disparate genetic etiologies may share mitochondrial dysfunction as a final common pathway. Recent studies using cybrid

  3. The Treatment of Erectile Dysfunction

    Microsoft Academic Search

    Nancy Gambescia; Shelley Kara Sendak

    2009-01-01

    Erectile dysfunction (ED) is a common age-related sexual dysfunction. It can be a treatment challenge for the therapist because it is notoriously associated with psychological, physical and relational risk factors. Typically, ED adversely impacts the man's self esteem, partner satisfaction and the couple's intimate relationship. This sexual dysfunction is often co-morbid with physical risk factors such as diabetes and cardiovascular

  4. Spontaneously hypertensive rats develop pulmonary hypertension and hypertrophy of pulmonary venous sphincters.

    PubMed Central

    Aharinejad, S.; Schraufnagel, D. E.; Böck, P.; MacKay, C. A.; Larson, E. K.; Miksovsky, A.; Marks, S. C.

    1996-01-01

    This study explored the spontaneously hypertensive rat as an animal model of pulmonary hypertension and sought to identify anatomic changes in its pulmonary microvasculature, especially focal constrictions of pulmonary veins (sphincters). The average systemic and pulmonary artery blood pressures were 172/139 (+/- 9/9) and 36/14 (+/- 4/3), respectively, for spontaneously hypertensive Wistar Kyoto rats (SHR), and 134/83 (+/- 8/2) and 20/10 (+/- 2/2) for normotensive Wistar Kyoto rats (WKY) (P < 0.01 for both). Light microscopy of the lungs in SHR showed muscularization of both arteries and veins, but this was more pronounced in the small pulmonary veins. Perivascular edema was also present. There were 20 (+/- 4) leukocytes per 100 microns of capillary length in SHR and 9 (+/- 2) in WKY (P < 0.001). Transmission electron microscopy showed focal venous smooth muscle was greater in SHR than in WKY. Scanning electron microscopy of vascular casts showed the average maximal focal venous contraction (sphincter) was 54% (+/- 10) of its diameter in SHR, but was only 6% (+/- 4) in WKY (P < 0.01). Arterial contraction occurred in the hypertensive rats as bourglass narrowings of the casts, but was less conspicuous than venous constrictions. The mean alveolar capillary diameter was 8.1 microns (+/- 1.6) in SHR, compared with 6.3 microns (+/- 1.0) in WKY (P < 0.01). The central interspace between capillaries was 3.2 microns (+/- 1.6) in SHR and 6.0 microns (+/- 3.6) in WKY (P < 0.01). The venous contraction, capillary size, and capillary interspace distance correlated with the pulmonary blood pressure. The spontaneously hypertensive rat can be a model of pulmonary hypertension with its most notable structural change being increased muscularity in the small pulmonary veins. Images Figure 1 Figure 2 Figure 3 and 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 to 13 Figure 14 and 15 PMID:8546217

  5. Preclinical Diastolic Dysfunction

    PubMed Central

    Wan, Siu-Hin; Vogel, Mark W.; Chen, Horng H

    2014-01-01

    Preclinical Diastolic Dysfunction (PDD) has been broadly defined as subjects with left ventricular diastolic dysfunction, without the diagnosis of congestive heart failure (HF), and with normal systolic function. PDD is an entity which remains poorly understood, yet has definite clinical significance. Although few original studies have focused on PDD, it has been shown that PDD is prevalent, and that there is a clear progression from PDD to symptomatic heart failure including dyspnea, edema, and fatigue. In diabetic patients and patients with coronary artery disease or hypertension, it has been shown that patients with PDD have a significantly higher risk of progression to heart failure and death compared to patients without PDD. Because of these findings and the increasing prevalence of the heart failure epidemic, it is clear that an understanding of PDD is essential to decreasing patients’ morbidity and mortality. This review will focus on what is known concerning preclinical diastolic dysfunction, including definitions, staging, epidemiology, pathophysiology, and the natural history of the disease. In addition, given the paucity of trials focused on PDD treatment, studies targeting risk factors associated with the development of PDD and therapeutic trials for heart failure with preserved ejection fraction will be reviewed. PMID:24291270

  6. [Differentiation of the effects of antispasmodic agents on the electromyogram of the sphincter of Oddi and the duodenum of the alert rabbit].

    PubMed

    Achard, F; Denavit, M; Roche, M

    1985-01-01

    The electrical activity of the sphincter of Oddi and gastro-intestinal tract had been recorded on 21 negative atropineesterase conscious rabbits by means of chronically implanted electrodes located in the digestive wall. An analysis of the action of different spasmolytic and analgesic drugs was realized. Electromyograms of the sphincter of Oddi presented (a) isolated or in series spike potentials occurring independently of electrical activities of the duodenum (b) recurring spike potentials correlated with intestine spikes. The independent activity of the sphincter of Oddi was not controlled by the cholinergic system, contrary to the intestine-dependent activity (effect of the fempiverinium, atropine like drug). The pitofenone had inhibited the spike potentials of both the sphincter and intestine because its papaverinic effect. The noramidopyrine, analgesic drug without morphine-like effects, had induced activation and inhibition at low and high posology respectively. PMID:2938675

  7. Association between NKX2-5 rs29784 and infantile hypertrophic pyloric stenosis in Chinese Han population

    PubMed Central

    Feng, Zhiqiang; Liang, Peizhi; Li, Qingning; Nie, Yuqiang; Zhang, Youxiang

    2015-01-01

    Purpose: The aim of this study was to evaluate the association of three single nucleotide polymorphisms (SNPs, rs11712066 and rs573872 near MBNL1, rs29784 near NKX2-5) with infantile hypertrophic pyloric stenosis (IHPS) in Chinese Han population. Methods: A total of 47 family trios consisting of infants with IHPS and their healthy biological parents were recruited for this study. Genotypes were determined using direct sequencing. Transmission disequilibrium test (TDT) was performed for family-based association analysis. Results: Genotypic distributions of three SNPs in both groups (patients and proband’s parents) were in conformity with Hardy-Weinberg equilibrium (P > 0.05). There were significant preferential transmission of A allele of rs29784 from the parents to affected offspring (TDT: x2 = 5.444, P = 0.0196). However, other two polymorphism loci (rs11712066 and rs573872) were not significant susceptibility loci for IHPS in Chinese Han population. Conclusions: We found that there was a significant association between rs29784 and IHPS. PMID:25932253

  8. Upper tract juvenile polyps in juvenile polyposis patients: dysplasia and malignancy are associated with foveolar, intestinal, and pyloric differentiation.

    PubMed

    Ma, Changqing; Giardiello, Francis M; Montgomery, Elizabeth A

    2014-12-01

    Patients with juvenile polyposis syndrome (JPS), a hereditary autosomal dominant hamartomatous polyposis syndrome, are at increased risk for colorectal adenocarcinoma. The upper gastrointestinal tract is less often involved by JPS than the colorectum, and, consequently, upper tract juvenile polyps (JPs) are not well studied. We reviewed upper endoscopies and corresponding biopsies in JPS patients documented in our Polyposis Registry. A total of 199 upper gastrointestinal biopsies from 69 endoscopies were available in 22 of 41 (54%) JPS patients. Thirteen of the 22 patients (59%) had ?1 gastric JP; 5 also had 6 small bowel JPs. Gastric JP was identified as early as age 7 in a patient with an SMAD4 gene mutation. Two patients (9%) had high-grade dysplasia in gastric JP. Invasive adenocarcinoma was diagnosed in the gastrectomy specimen of 1 patient. Five patients had a huge gastric polyp burden; 3 underwent total gastrectomy. Three patients died of complications associated with extensive upper JP. Histologically, 8 of the 56 (14%) gastric JPs identified had dysplasia. All of the 8 polyps demonstrated intestinalized and pyloric gland differentiation intermixed with foveolar epithelium. Dysplasia was seen arising in all 3 types of epithelium. The flat gastric mucosa in 11 patients was unremarkable without inflammation or intestinal metaplasia. The 6 small bowel JPs had no dysplasia. Our findings suggest that JPS patients are at increased risk for gastric adenocarcinoma. Detection of malignancy in syndromic gastric JP indicates that the current screening procedures are insufficient in removal of precursor lesions to prevent progression to carcinoma. PMID:25390638

  9. Approach to the male patient with lower urinary tract dysfunction.

    PubMed

    Wyndaele, Jean Jacques; Vodušek, David B

    2015-01-01

    History and physical examination are the cornerstones of evaluation of the male patient with lower urinary tract (LUT) symptoms and (suspected) neurologic disorder, both to diagnose the nervous system lesion, and to get insight into the type of LUT dysfunction (LUTD). Non-neurologic LUTD needs to be ruled out. Laboratory testing is necessary to diagnose urinary infection. In those in whom neurogenic LUTD is probable, postvoid residual urine and urinary flow measurement generally rule out significant outflow obstruction and allow for basic symptomatic management. If symptomatology is complex or severe, or the pathophysiology uncertain, or invasive treatment planned, urodynamic or videourodynamic measurements should be performed to inform on bladder sensation, detrusor contractility, pressures generated in the bladder, as well as the behavior of bladder neck, the striated urethral sphincter, and urinary flow. This information is paramount to the clinician to plan management and consider prognosis. Assessment needs to be repeated, as chronic neurogenic LUTD is not a stable condition; in progressive neurologic diseases the nature of LUTD itself may change. The upper urinary tract needs to be checked and followed up regularly, particularly in patient groups in which high intravesical pressures may be generated. PMID:26003243

  10. Multivariate Analysis of Risk Factors Associated With the Nonreversal Ileostomy Following Sphincter-Preserving Surgery for Rectal Cancer

    PubMed Central

    Kim, Young Ah; Lee, Gil Jae; Park, Sung Won; Lee, Won-Suk

    2015-01-01

    Purpose A loop ileostomy is used to protect an anastomosis after anal sphincter-preserving surgery, especially in patients with low rectal cancer, but little information is available concerning risk factors associated with a nonreversal ileostomy. The purpose of this study was to identify risk factors of ileostomy nonreversibility after a sphincter-saving resection for rectal cancer. Methods Six hundred seventy-nine (679) patients with rectal cancer who underwent sphincter-preserving surgery between January 2004 and December 2011 were evaluated retrospectively. Of the 679, 135 (19.9%) underwent a defunctioning loop ileostomy of temporary intent, and these patients were divided into two groups, that is, a reversal group (RG, 112 patients) and a nonreversal group (NRG, 23 patients) according to the reversibility of the ileostomy. Results In 23 of the 135 rectal cancer patients (17.0%) that underwent a diverting ileostomy, stoma reversal was not possible for the following reasons; stage IV rectal cancer (11, 47.8%), poor tone of the anal sphincter (4, 17.4%), local recurrence (2, 8.7%), anastomotic leakage (1, 4.3%), radiation proctitis (1, 4.3%), and patient refusal (4, 17.4%). The independent risk factors of the nonreversal group were anastomotic leakage or fistula, stage IV cancer, local recurrence, and comorbidity. Conclusion Postoperative complications such as anastomotic leakage or fistula, advanced primary disease (stage IV), local recurrence and comorbidity were identified as risk factors of a nonreversal ileostomy. These factors should be considered when drafting prudential guidelines for ileostomy closure. PMID:26161377

  11. Management of ejaculatory dysfunction.

    PubMed

    McMahon, C G

    2014-02-01

    Ejaculatory dysfunction is a common complaint and is often associated with a reduced quality of life for sufferer and partner. The spectrum of ejaculatory dysfunction extends from premature ejaculation (PE) to delayed ejaculation (DE) and anejaculation. Over the past 20-30 years, the PE treatment paradigm, previously limited to behavioural psychotherapy, has expanded to include drug treatment. Multiple well-controlled, evidence-based studies have demonstrated the efficacy and safety of selective serotonin re-uptake inhibitors in delaying ejaculation, confirming their role as first-line agents for the treatment of lifelong and acquired PE. More recently, there has been increased attention to the psychosocial consequences of PE, its epidemiology, its aetiology and its pathophysiology by both clinicians and the pharmaceutical industry. DE and anejaculation are probably the least common, least studied and least understood of the male sexual dysfunctions. However, their impact is significant as they may result in a lack of sexual fulfilment for both the man and his partner, an effect further compounded when procreation is among the couple's goals of sexual intercourse. The causes of DE, anejaculation and anorgasmia are manifold. Numerous psychotherapeutic treatments are described for the management of delayed or anejaculation. Although some appear to be effective, none has been properly evaluated in large-scale samples. Treatment of DE or anejaculation with pharmacotherapy has met with limited success. No drugs have been approved by regulatory agencies for this purpose, and most drugs that have been identified for potential use have limited efficacy, impart significant side-effects or are yet considered experimental in nature. PMID:24528812

  12. Multiple organ dysfunction syndrome.

    PubMed Central

    Murray, M. J.; Coursin, D. B.

    1993-01-01

    The multiple organ dysfunction syndrome (MODS), though newly described, has manifested itself in intensive care unit (ICU) patients for several decades. As the name implies, it is a syndrome in which more than one organ system fails. Failure of these multiple organ systems may or may not be related to the initial injury or disease process for which the patient was admitted to the ICU. MODS is the leading cause of morbidity and mortality in current ICU practice. While the pathophysiology of MODS is not completely known, much evidence indicates that, during the initial injury which precipitates ICU admission, a chain of events is initiated which results in activation of several endogenous metabolic pathways. These pathways release compounds which, in and of themselves, are usually cytoprotective. However, an over exuberant activation of these endogenous systems results in an inflammatory response which can lead to development of failure in distant organs. As these organs fail, they activate and propagate the systemic inflammatory response. No therapy has proven entirely efficacious at modulating this inflammatory response and the incidence and severity of MODS. In current ICU practice, treatment is focused on prevention and treating individual organ dysfunction as it develops. With increased understanding of the pathophysiology of MODS therapy will come newer modalities which inhibit or interfere with the propagation of the endogenous systemic inflammatory response. These newer therapies hold great promise and already some are undergoing clinical investigation. PMID:7825351

  13. Purse-string morphology of external anal sphincter revealed by novel imaging techniques

    PubMed Central

    Bhargava, Valmik; Sheean, Geoff; Ledgerwood, Melissa; Sinha, Shantanu

    2014-01-01

    The external anal sphincter (EAS) may be injured in 25–35% of women during the first and subsequent vaginal childbirths and is likely the most common cause of anal incontinence. Since its first description almost 300 years ago, the EAS was believed to be a circular or a “donut-shaped” structure. Using three-dimensional transperineal ultrasound imaging, MRI, diffusion tensor imaging, and muscle fiber tracking, we delineated various components of the EAS and their muscle fiber directions. These novel imaging techniques suggest “purse-string” morphology, with “EAS muscles” crossing contralaterally in the perineal body to the contralateral transverse perineal (TP) and bulbospongiosus (BS) muscles, thus attaching the EAS to the pubic rami. Spin-tag MRI demonstrated purse-string action of the EAS muscle. Electromyography of TP/BS and EAS muscles revealed their simultaneous contraction and relaxation. Lidocaine injection into the TP/BS muscle significantly reduced anal canal pressure. These studies support purse-string morphology of the EAS to constrict/close the anal canal opening. Our findings have implications for the effect of episiotomy on anal closure function and the currently used surgical technique (overlapping sphincteroplasty) for EAS reconstructive surgery to treat anal incontinence. PMID:24458022

  14. Characterization of substance P effects on sphincter of Oddi myoelectric activity.

    PubMed

    Parodi, J E; Zenilman, M E; Becker, J M

    1989-05-01

    We examined the effects of substance P (SP) on the myoelectric activity of the opossum sphincter of Oddi (SO). Myoelectric data from the SO in five adult opossums were recorded using thin stainless steel electrodes and computer-assisted analog-to-digital conversion. In fully awake and conscious animals, baseline spikeburst activity during phase I of the MMC occurred at a frequency of 28.6 +/- 3.1 spikebursts (SB) per 20-min period. Intravenous infusion of graded doses of substance P (from 0.5 to 8.0 micrograms/kg) stimulated SO myoelectric activity in a dose-related manner (from 80 +/- 8 to 235 +/- 11 SB/20 min, respectively, P less than 0.05 when compared to baseline). The effect of substance P on SO myoelectric activity was antagonized by administration of the H2-blocker, cimetidine (92.0 +/- 6.1 vs 48.2 +/- 7.0, n = 5, P less than 0.05). Administration of the antimuscarinic drug atropine only slightly affected the SO spikeburst frequency when infused prior to SP (73.0 +/- 10.4 vs 70.8 +/- 8.2, P greater than 0.05). We conclude that SP stimulated the SO spikeburst frequency in a dose-dependent fashion. Cimetidine markedly inhibited the response of the SO to SP but atropine did not. The excitatory effect of substance P on the opossum SO is mediated at least in part by a histaminergic, noncholinergic pathway. PMID:2469860

  15. Purse-string morphology of external anal sphincter revealed by novel imaging techniques.

    PubMed

    Mittal, Ravinder K; Bhargava, Valmik; Sheean, Geoff; Ledgerwood, Melissa; Sinha, Shantanu

    2014-03-01

    The external anal sphincter (EAS) may be injured in 25-35% of women during the first and subsequent vaginal childbirths and is likely the most common cause of anal incontinence. Since its first description almost 300 years ago, the EAS was believed to be a circular or a "donut-shaped" structure. Using three-dimensional transperineal ultrasound imaging, MRI, diffusion tensor imaging, and muscle fiber tracking, we delineated various components of the EAS and their muscle fiber directions. These novel imaging techniques suggest "purse-string" morphology, with "EAS muscles" crossing contralaterally in the perineal body to the contralateral transverse perineal (TP) and bulbospongiosus (BS) muscles, thus attaching the EAS to the pubic rami. Spin-tag MRI demonstrated purse-string action of the EAS muscle. Electromyography of TP/BS and EAS muscles revealed their simultaneous contraction and relaxation. Lidocaine injection into the TP/BS muscle significantly reduced anal canal pressure. These studies support purse-string morphology of the EAS to constrict/close the anal canal opening. Our findings have implications for the effect of episiotomy on anal closure function and the currently used surgical technique (overlapping sphincteroplasty) for EAS reconstructive surgery to treat anal incontinence. PMID:24458022

  16. Effect of Micturition on the External Anal Sphincter: Identification of the Urethro–Anal Reflex

    PubMed Central

    Shafik, Ahmed; Sibai, Olfat El; Shafik, Ismail; Shafik, Ali A

    2005-01-01

    Background/Objective: A study on the response of the external anal sphincter (EAS) to the passage of urine through the urethra during micturition could not be found in the literature. We investigated the hypothesis that urine passage through the urethra effects EAS contraction to guard against possible flatus or stool leakage during micturition. Methods: The study was performed in 23 healthy volunteers (age, 38.6 ± 10.8 [SD] years; 14 men and 9 women). The EAS electromyogram (EMG) was performed during micturition by surface electrodes applied to the EAS. Also, the EAS EMG response to urethral stimulation by a catheter-mounted electrode was registered. The test was repeated after individual anesthetization of the EAS and urethra. Results: The EAS EMG recorded a significant increase (P < 0.01) during micturition and on urethral stimulation at the bladder neck. Stimulation of the prostatic, membranous, or penile urethra produced no significant change in the EAS EMG. Urethral stimulation after individual EAS and urethral anesthetization did not cause any changes in the EAS EMG. Conclusions: Urine passing through the urethra or urethral stimulation at the vesical neck produced an increase in the EAS EMG, which presumably denotes EAS contraction, which seems to guard against flatus or fecal leakage during micturition. EAS contraction on urethral stimulation is suggested to be mediated through a urethro–anal reflex. Further studies on this issue may potentially prove the diagnostic significance of this reflex in micturition and defecation disorders. PMID:16869089

  17. Tachykinins mediate slow excitatory postsynaptic transmission in guinea pig sphincter of Oddi ganglia.

    PubMed

    Manning, B P; Mawe, G M

    2001-08-01

    Intracellular recording techniques were used to test whether tachykinins could be mediators of slow excitatory postsynaptic potentials (EPSPs) in guinea pig sphincter of Oddi (SO) ganglia. Application of the tachykinin substance P (SP) onto SO neurons caused a prolonged membrane depolarization that was reminiscent of the slow EPSP in these cells. Pressure ejection of the neurokinin 3 (NK3) receptor-specific agonist senktide caused a similar depolarization; however, no responses were detected on application of NK1 or NK2 receptor agonists. The NK3 receptor antagonist SR-142801 (100 nM) significantly inhibited both SP-induced depolarization and the stimulation-evoked slow EPSP, as did NK3 receptor desensitization with senktide. Capsaicin, which causes the release of SP from small-diameter afferent fibers, induced a depolarization that was similar to the evoked slow EPSP in both amplitude and duration. The capsaicin-induced depolarization was significantly attenuated in the presence of SR-142801. These data indicate that tachykinins, released from extrinsic afferent fibers, act via NK3 receptors to provide slow excitatory synaptic input to SO neurons. PMID:11447015

  18. Characterization of NK3 receptors in rabbit isolated iris sphincter muscle

    PubMed Central

    Medhurst, Andrew D; Parsons, Andrew A; Roberts, Jennifer C; Hay, Douglas W P

    1996-01-01

    Tachykinin NK3 receptors were characterized in the rabbit isolated iris sphincter muscle by use of autoradiography and in vitro functional studies.[125I]-[MePhe7]-neurokinin B (NKB) (1?nM), a selective NK3 receptor agonist, specifically labelled a population of NK3 receptors that were uniformly distributed throughout the rabbit iris sphincter muscle. This labelling was inhibited by unlabelled [MePhe7]-NKB (1??M) but not by the NK1 receptor antagonist CP 99994 (1??M).In the presence of CP 99994 (1??M), the selective NK3 receptor agonists senktide (n=14) and [Pro7]-NKB (n=4), and the natural preferred ligand for the NK3 receptor, NKB (n=8), were potent contractile agents in the rabbit iris sphincter muscle. They all produced monophasic concentration-effect curves with pD2 values of 9.53±0.08, 8.56±0.09 and 9.75±0.09, and nH values of 0.93±0.03, 1.53±0.17 and 0.76±0.06, respectively. [MePhe7]-NKB (n=12) was also a potent agonist, but produced shallow concentration-effect curves which appeared biphasic (nH=0.45±0.04).Contractile responses to senktide were surmountably antagonized in a concentration-dependent manner by the selective non-peptide NK3 receptor antagonist, SR 142801 (3–30?nM; pA2= 8.9; slope = 0.99) and the non-peptide NK2/NK3 receptor antagonist, SR 48968 (3–30??M; pA2 =6.1; slope=1.5). These pA2 values were consistent with functional rabbit NK3 receptors more closely resembling guinea-pig and human NK3 receptors, than rat NK3 receptors. SR 142801 (10–100?nM) and SR 48968 (3 and 30??M) inhibited responses to low (?1?nM) but not higher (>1?nM) concentrations of [MePhe7]-NKB, and concentration-effect curves to [MePhe7]-NKB became steeper and monophasic in the presence of either antagonist.SR 142801 (3–30 nM) and SR 48968 (3–30??M) also surmountably antagonized concentration-effect curves to [Pro7]-NKB and NKB, although results were more difficult to interpret, since the relationship between log concentration-ratios and the concentration of antagonist used did not adhere to the Schild equation. However, analysis of data with the lowest concentration of SR 142801 (3?nM) tested against NKB, and SR 48968 (3??M) tested against [Pro7]-NKB and NKB, yielded apparent pA2 estimates of 9.3, 6.8 and 6.4, respectively, consistent with blockade of NK3 receptors.SR 142801 (100?nM) had no effect on contractions induced by transmural nerve stimulation (2?Hz, 0.3?ms, 20?V for 30?s), whereas CP 99994 (1??M) abolished these responses.Phenoxybenzamine pretreatment (20??M, 10?min) markedly reduced maximum responses to [MePhe7]-NKB (from 101±6.2% to 38±9.5% reference contraction, n=4) and induced a marked (10?fold) rightward shift in the concentration-effect curve. The residual responses to [MePhe7]-NKB after phenoxybenzamine pretreatment were unaffected by 1??M CP 99994 (maximum response=41±9.4%, n=4).These results demonstrate autoradiographically and functionally, the presence of NK3 receptors in rabbit iris sphincter muscle that mediate contractile responses to NK3 receptor agonists, but not to sensory trigeminal nerve stimulation. The present data with senktide and selective NK3 receptor antagonists suggest that functional rabbit NK3 receptors more closely resemble human and guinea-pig NK3 receptors than rat NK3 receptors. However, the pharmacological profiles of [MePhe7]-NKB, SR 142801 and SR 48968 suggest the presence of an ‘atypical' NK3 receptor or a heterogeneous population of NK3 receptors in this tissue. PMID:9117105

  19. Surgical treatment of tumors of the distal rectum with sphincter preservation.

    PubMed Central

    Heimann, T M; Oh, C; Steinhagen, R M; Greenstein, A J; Perez, C; Aufses, A H

    1992-01-01

    One hundred one patients with villous adenoma or invasive carcinoma of the distal rectum treated with local excision or coloanal anastomosis were studied. Twenty-three (45%) of the 51 patients with villous adenomas had transanal excision, another 23 (45%) had a posterior proctotomy, and five (10%) had a coloanal anastomosis. Only two patients with a villous adenoma developed a recurrence requiring repeat local excision. Fifteen (30%) of the 50 patients with invasive cancer were treated by transanal excision. All had tumors confined to the submucosa or superficial muscularis. Eighteen (85%) of 21 patients having posterior proctotomy also had tumors with similar depth of invasion. Six (43%) of the 14 patients having coloanal anastomosis had Dukes' B tumors, six (43%) were Dukes' C, and another two (14%) underwent palliative resection. The overall actuarial 5-year survival was 77%. Only four patients treated by transanal excision or posterior proctotomy died of metastatic disease. In the coloanal group, two of 12 patients undergoing curative resection died of recurrent cancer, and another has a pelvic recurrence. Villous adenomas of the distal rectum and selected carcinomas may be treated with local excision and coloanal anastomosis with preservation of sphincter function with good results. PMID:1417192

  20. Low rectal cancer: Sphincter preserving techniques-selection of patients, techniques and outcomes

    PubMed Central

    Dimitriou, Nikoletta; Michail, Othon; Moris, Dimitrios; Griniatsos, John

    2015-01-01

    Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity and to improve both the oncological as well as the functional outcomes, have been emerged. Literature suggest that when the intersphincteric resection is applied in T1-3 tumors located within 30-35 mm from the anal verge, is technically feasible, safe, with equal oncological outcomes compared to conventional surgery and acceptable quality of life. The Anterior Perineal PlanE for Ultra-low Anterior Resection technique, is not disrupting the sphincters, but carries a high complication rate, while the reports on the oncological and functional outcomes are limited. Transanal Endoscopic MicroSurgery (TEM) and TransAnal Minimally Invasive Surgery (TAMIS) should represent the treatment of choice for T1 rectal tumors, with specific criteria according to the NCCN guidelines and favorable pathologic features. Alternatively to the standard conventional surgery, neoadjuvant chemo-radiotherapy followed by TEM or TAMIS seems promising for tumors of a local stage T1sm2-3 or T2. Transanal Total Mesorectal Excision should be performed only when a board approved protocol is available by colorectal surgeons with extensive experience in minimally invasive and transanal endoscopic surgery. PMID:26191350

  1. A synthetic prostaglandin E1 analog, alprostadil alfadex, relaxes sphincter of Oddi in humans.

    PubMed

    Koshitani, Tatsuya; Kodama, Tadashi; Sato, Hideki; Takaaki, Junpei; Imamura, Yoichi; Kato, Keimei; Wakabayashi, Naoki; Tokita, Kazuhiko; Mitsufuji, Shoji

    2002-01-01

    It is well established that prostaglandins (PGs) exert potent pharmacological actions on vascular and nonvascular smooth muscle, although their effects on the sphincter of Oddi (SO) remain to be elucidated. The aim of this study was to investigate the effect of PGE1 on motility of the human SO. Twenty patients appearing for routine endoscopic retrograde cholangiopancreatography (ERCP) examination were studied. Each patient was randomly allocated to receive an intravenous infusion of normal saline (six patients), or alprostadil alfadex, a synthetic PGE1 analog, at a dose of either 0.05 or 0.1 microg/kg/min (seven patients for each condition). Endoscopic biliary manometry was done with a recording of basal SO pressure, amplitude of SO phasic contractions, and phasic contractile frequency before and 5 min after intravenous infusions, using a 4-French microtransducer catheter. There was no significant change in SO motor variables following application of normal saline. Alprostadil alfadex significantly decreased basal SO pressure at a dose of 0.05 microg/kg/min, and significantly decreased all parameters at a dose of 0.1 microg/kg/min. A synthetic PGE1 analog, alprostadil alfadex, effectively inhibits motility of the human SO. This drug may be of clinical application as a SO-relaxing agent. PMID:11837717

  2. Aberrant expression of pyloric gland-type mucin in mucin-producing bile duct carcinomas: a clear difference between the core peptide and the carbohydrate moiety.

    PubMed

    Goto, Masamichi; Shibahara, Hiroaki; Tamada, Shugo; Hamada, Tomofumi; Oda, Koji; Nagino, Masato; Nagasaka, Tetsuro; Imai, Kohzoh; Nimura, Yuji; Yonezawa, Suguru

    2005-08-01

    The authors have recently defined the clinopathological entity of a mucin-producing bile duct tumor (MPBT), and divided MPBT into two distinct subtypes: 'columnar-type' and 'cuboidal-type' MPBT. Mucin core protein 6 (MUC6), which is present in normal pyloric glands, had higher expression levels in cuboidal-type tumors than in columnar-type tumors. In the pyloric glands, a carbohydrate antigen detected by monoclonal antibody HIK1083 (CA/HIK1083) is also expressed. In order to evaluate the coexpression pattern of MUC6 and CA/HIK1083 in MPBT, expression profiles were evaluated in 38 surgically excised mucin-producing bile duct carcinomas (MPBC; cuboidal-type, n = 15; columnar-type, n = 23), using immunohistochemistry. The staining rate was graded as follows: -, <5% of neoplastic cells stained; +, 5% to <20%; + +, 20% to <50%; + + +, > or =50%. In cuboidal-type MPBC, MUC6 was positive in all cases (+ + +, 13/15; + +, 1/15; +, 1/15), whereas CA/HIK1083 was negative in all cases (-, 15/15; P < 0.0001). In columnar-type MPBC, MUC6 was positive in 65% of cases (+ + +, 6/23; + +, 8/23; +, 1/23; -, 8/23), and CA/HIK1083 was positive in 52% (+ +, 3/23; +, 9/23; -, 11/23; not significant). Our results clearly demonstrate that cuboidal-type MPBC have an aberrant pyloric glandular phenotype, that is, MUC6+/CA/HIK1083-. This unique profile may be related to different outcomes of patients with MPBC. PMID:15998373

  3. Metal-sensitive and thermostable trypsin from the crevalle jack (Caranx hippos) pyloric caeca: purification and characterization

    PubMed Central

    2013-01-01

    Background Over the past decades, the economic development and world population growth has led to increased for food demand. Increasing the fish production is considered one of the alternatives to meet the increased food demand, but the processing of fish leads to by-products such as skin, bones and viscera, a source of environmental contamination. Fish viscera have been reported as an important source of digestive proteases with interesting characteristics for biotechnological processes. Thus, the aim of this study was to purify and to characterize a trypsin from the processing by-products of crevalle jack (Caranx hippos) fish. Results A 27.5 kDa trypsin with N-terminal amino acid sequence IVGGFECTPHVFAYQ was easily purified from the pyloric caeca of the crevalle jack. Its physicochemical and kinetic properties were evaluated using N-?-benzoyl-DL-arginine-p-nitroanilide (BApNA) as substrate. In addition, the effects of various metal ions and specific protease inhibitors on trypsin activity were determined. Optimum pH and temperature were 8.0 and 50°C, respectively. After incubation at 50°C for 30 min the enzyme lost only 20% of its activity. K m , k cat, and k cat /K m values using BApNA as substrate were 0.689 mM, 6.9 s-1, and 10 s-1 mM-1, respectively. High inhibition of trypsin activity was observed after incubation with Cd2+, Al3+, Zn2+, Cu2+, Pb2+, and Hg2+ at 1 mM, revealing high sensitivity of the enzyme to metal ions. Conclusions Extraction of a thermostable trypsin from by-products of the fishery industry confirms the potential of these materials as an alternative source of these biomolecules. Furthermore, the results suggest that this trypsin-like enzyme presents interesting biotechnological properties for industrial applications. PMID:24112762

  4. Bladder Dysfunction and Vesicoureteral Reflux

    PubMed Central

    Sillén, Ulla

    2008-01-01

    In this overview the influence of functional bladder disturbances and of its treatment on the resolution of vesicoureteral reflux (VUR) in children is discussed. Historically both bladder dysfunction entities, the overactive bladder (OAB) and the dysfunctional voiding (DV), have been described in conjunction with VUR. Treatment of the dysfunction was also considered to influence spontaneous resolution in a positive way. During the last decades, however, papers have been published which could not support these results. Regarding the OAB, a prospective study with treatment of the bladder overactivity with anticholinergics, did not influence spontaneous resolution rate in children with a dysfunction including also the voiding phase, DV and DES (dysfunctional elimination syndrome), most studies indicate a negative influence on the resolution rate of VUR in children, both before and after the age for bladder control, both with and without treatment. However, a couple of uncontrolled studies indicate that there is a high short-term resolution rate after treatment with flow biofeedback. It should be emphasized that the voiding phase dysfunctions (DV and DES) are more severe than the genuine filling phase dysfunction (OAB), with an increased frequency of UTI and renal damage in the former groups. To be able to answer the question if treatment of bladder dysfunction influence the resolution rate of VUR in children, randomized controlled studies must be performed. PMID:19009037

  5. Sexual dysfunction after pelvic surgery

    Microsoft Academic Search

    C Zippe; K Nandipati; A Agarwal; R Raina

    2006-01-01

    Pelvic surgeries are among the most common causes of organic sexual dysfunction in men and women. The impact of nerve-sparing surgery on potency has been well documented in radical prostatectomy. However, its impact on potency needs to be evaluated in other pelvic surgeries. Sexual dysfunction is highly prevalent even after multiple technical advances in the field of oncological surgeries. The

  6. [Thyroid dysfunction in pregnancy].

    PubMed

    Führer, D; Mann, K; Feldkamp, J; Krude, H; Spitzweg, C; Kratzsch, J; Schott, M

    2014-10-01

    Thyroid dysfunction may impair fertility, course of pregnancy and fetal development. Physiological alterations of thyroid function parameters, that occur during pregnancy need to be distinguished from pathophysiological states of hypo- and hyperthyroidism. We performed a literature search (PubMed 1990-2013) and review relevant publications as well as consensus and practice guidelines of international thyroid/endocrine societies. Interpretation of thyroid function values in pregnancy must be based on trimester-specific TSH and T4 ranges. Alterations in thyroid function are present in up to 15% of pregnancies (0.4% overt hypothyroidism, 0.1-0.4% hyperthyroidism) and may lead to preventable complications in the pregnant woman and the fetus. Hypothyroidism is associated with an increased risk for abortion, premature delivery and stillbirth, besides impairment of neurocognitive development. The latter has also been shown in situations of grave iodine deficiency. In addition to new-born screening directed at early recognition of congenital hypothyroidism (incidence 0.03%), universal screening of all pregnant women should be implemented in health care guidelines. Newly diagnosed overt hypothyroidism in a pregnant woman requires immediate levothyroxine substitution at adequate doses. In subclinical hypothyroidism thyroid hormone replacement should be considered. Iodine supplementation is strongly recommended in all pregnant and breast-feeding women. Pregnancy causes a number of, that need to be of thyroid dysfunction. Both hypothyroidism and thyrotoxicosis may impair the course of pregnancy and may negatively affect the fetus. In particular, maternal hypothyroidism may lead to irreparable and detrimental deficits in the neurocognitive development of the fetus. Autoimmune thyroid disease is the most common cause of thyroid dysfunction in pregnancy. Hashimoto's thyroiditis is associated with impaired fertility and miscarriage, and may first manifest in pregnancy due to the increased thyroid hormone requirement. Graves' disease often shows a characteristic course in pregnancy with amelioration of thyrotoxicosis in the second half of pregnancy and exacerbation after delivery. In addition transplacental passage of maternal TSH receptor antibodies may lead to thyrotoxicosis in the fetus and/or newborn. PMID:25289925

  7. Erectile Dysfunction Drugs and Serious Skin Cancer

    MedlinePLUS Videos and Cool Tools

    ... videos/news/Erectile_Dysfunction_062415.html Erectile Dysfunction Drugs and Serious Skin Cancer HealthDay News Video - June ... page, please enable JavaScript. Play video: Erectile Dysfunction Drugs and Serious Skin Cancer For closed captioning, click ...

  8. Female sexual dysfunction.

    PubMed

    Freedman, Murray A

    2002-01-01

    Happiness is an attitude, not an event! The glass is either half-full or half-empty; it simply depends on the viewer. Some rich people are miserable...some poor people are ecstatic. You cannot change the world but you can change yourself. You, and you alone, control your destiny. With very little practice, you can learn to think positively. Postmenopausal estrogen deficiency leads to urogenital atrophy. Sexual dysfunction and urinary dysfunction are the most inevitable but least publicized consequences of estrogen deficiency, and these represent important quality-of-life issues that patients and health care providers are often reluctant to discuss. In addition to estrogen deficiency, oophorectomized women may be subject to androgen deficiency and problems with libido. While the relationship with one's partner is the quintessential factor in female sexuality, hormone deficiency remains important, especially in reference to genital atrophy. Humans are the products of learned behavior. We literally become what we think. "I am sick and tired" becomes a self-fulfilling prophecy. Self-esteem represents learned behavior just as ego does...but there is a world of difference between the two. Sexuality is enhanced by good self-esteem and hindered by ego: two partners working together can reach far greater heights than either alone ever imagined...one and one can equal three! There are good data to substantiate that happy people have more sex and that people who have more sex are happier. Partners need to learn to honor one another, communicate in a positive manner, develop touching salutations, be a spouse at home, and make their bedroom a sacred sanctuary. With a little behavior modification and hormone therapy, sexuality can remain a priority ad infinitum. PMID:11900270

  9. Optimal Design of Litz Wire Coils With Sandwich Structure Wirelessly Powering an Artificial Anal Sphincter System.

    PubMed

    Ke, Lei; Yan, Guozheng; Yan, Sheng; Wang, Zhiwu; Li, Xiaoyang

    2015-07-01

    Transcutaneous energy transfer system (TETS) is widely used to energize implantable biomedical devices. As a key part of the TETS, a pair of applicable coils with low losses, high unloaded Q factor, and strong coupling is required to realize an efficient TETS. This article presents an optimal design methodology of planar litz wire coils sandwiched between two ferrite substrates wirelessly powering a novel mechanical artificial anal sphincter system for treating severe fecal incontinence, with focus on the main parameters of the coils such as the wire diameter, number of turns, geometry, and the properties of the ferrite substrate. The theoretical basis of optimal power transfer efficiency in an inductive link was analyzed. A set of analytical expressions are outlined to calculate the winding resistance of a litz wire coil on ferrite substrate, taking into account eddy-current losses, including conduction losses and induction losses. Expressions that describe the geometrical dimension dependence of self- and mutual inductance are derived. The influence of ferrite substrate relative permeability and dimensions is also considered. We have used this foundation to devise an applicable coil design method that starts with a set of realistic constraints and ends with the optimal coil pair geometries. All theoretical predictions are verified with measurements using different types of fabricated coils. The results indicate that the analysis is useful for optimizing the geometry design of windings and the ferrite substrate in a sandwich structure as part of which, in addition to providing design insight, allows speeding up the system efficiency-optimizing design process. PMID:25808086

  10. Comparing Argus sling and artificial urinary sphincter in patients with moderate post-prostatectomy incontinence

    PubMed Central

    Lim, Bumjin; Kim, Aram; Song, Miho; Chun, Ji-Youn; Park, Junsoo; Choo, Myung-Soo

    2014-01-01

    Post-prostatectomy incontinence (PPI) is a main complication of radical prostatectomy. The purpose of this study was to compare the efficacy and safety of the Argus male sling (Argus) with that of artificial urinary sphincters (AUS) in patients with moderate PPI. A total of 33 moderate PPI patients underwent AUS or Argus implantation from January 2009 to June 2013 (13 AUS, 20 Argus). We defined moderate PPI as the use of 2–4 pads per day. To compare efficacy, we assessed the success rate between the two groups. Success was defined as the daily need for no pads or one small safety pad that remained dry most of the day. The mean patient age was 73.5±6.3 yr in the AUS group and 70.9±5.1 yr in the Argus group, and the mean follow-up period was 29.8±14.9 months in the AUS group and 24.7±11.8 months in the Argus group. The success rate was 72.7% in the AUS group and 85.0% in the Argus group (P=0.557). Abnormal postoperative pain persisted in more patients in the Argus group (6/20, 30%) than in the AUS group (1/13, 7.7%) (P=0.126). However, the rate of other complications was not different between the two groups (7.7% and 15.0% for AUS and Argus, respectively, P=0.822). Argus surgery showed similar success and complication rates to those of AUS in moderate PPI patients, indicating that it could be an alternative surgical option for the treatment of moderate PPI. PMID:25426474

  11. Typical and atypical NK1 tachykinin receptor characteristics in the rabbit isolated iris sphincter.

    PubMed Central

    Hall, J. M.; Mitchell, D.; Morton, I. K.

    1994-01-01

    1. A contraction of the rabbit isolated iris sphincter smooth muscle follows activation of either tachykinin NK1 or NK3 receptors. We have here characterized the pharmacological activity profiles of various tachykinin receptor agonists considered to have NK1-receptor-preferring activity in this preparation. 2. Two groups of NK1-receptor-preferring agonists could be distinguished in terms of a common pharmacological profile. The first group (Group 1) included [Glp6,L-Pro9]-SP(6-11) (septide), [Glp6]-SP (6-11), substance P methyl ester, delta-aminovaleryl-[L-Pro9, N-MeLeu10]-SP(7-11) (GR73632), and [Apa9-10]-SP. The second group (Group 2) included [Pro9]-SP, substance P, physalaemin and ranamargarin. 3. Under control conditions, the responses to Group 1 agonists were relatively fast in offset (time for reversal of maximal responses, 11.2-18.2 min), and were antagonized by NK1-receptor-selective antagonists (range of pKB estimates vs various agonists; GR82334, 7.1-8.2; (+/-)-CP-96,345, 8.9-9.5; RP67580, 7.0-7.4). Following incubation of the tissue with phenoxybenzamine (20 microM, 10 min), the affinity of GR82334, tested against the Group 1 agonists, substance P methyl ester and septide, was not significantly different (P < 0.05; n = 7-18) to that determined in untreated tissues (substance P methyl ester pKB 7.5 +/- 0.1 and 7.2 +/- 0.2, respectively; septide 7.7 +/- 0.2 and 7.9 +/- 0.2, respectively). Further, response offset times (5.0-8.5 min) were little reduced as compared to those observed in untreated tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7522864

  12. New insights in the neural regulation of the lower oesophageal sphincter.

    PubMed

    Blackshaw, L Ashley

    2008-08-01

    Gastro-oesophageal reflux disease (GORD) is caused by disordered control of the gastro-oesophageal reflux barrier, comprised internally of the lower oesophageal sphincter (LOS) and externally the crural diaphragm (CD). Both relax briefly to allow bolus passage during oesophageal peristalsis. Brief relaxation also occurs prior to gastro-oesophageal reflux, known as transient LOS relaxation (TLOSR), normally allowing venting of gas. TLOSRs also account for up to 90% of acid reflux episodes. The development of GORD therefore depends upon the rate of TLOSR and the physical and chemical nature of refluxate. We established an animal model of reflux in ferrets, in which similar patterns of TLOSR are seen to humans. TLOSRs are mediated via a vago-vagal pathway initiated by tension receptors in the gastric musculature. They have central terminals in the brainstem which provide input to a central program generator. The program has 3 simultaneous outputs: 1. brief activation of vagal motor neurones to the LOS, which activate inhibitory enteric motorneurones, leading to smooth muscle relaxation: 2. suppression of oesophageal peristalsis: 3. suppression of motor output to the CD. We have investigated several aspects of the TLOSR pathway in ferrets, and determined that the optimal site for therapeutic pharmacological intervention is at gastric vagal tension receptor endings. Their responses to distension are potently inhibited by gamma-aminobutyric acid type B (GABAB) receptor agonists and metabotropic glutamate type 5 receptor (mGluR5) antagonists. These effects translate to inhibition of TLOSR and reflux in animal models and humans. Clinical studies indicate both types of drug may have potential in the treatment of GORD. PMID:18924442

  13. Videofluoroscopic and Manometric Evaluation of Pharyngeal and Upper Esophageal Sphincter Function During Swallowing

    PubMed Central

    Yoon, Kyung Jae; Park, Jung Ho; Park, Jung Hwan; Jung, Il Seok

    2014-01-01

    Background/Aims The purpose of this study was to determine important manometric metrics for the analysis of pharyngeal and upper esophageal sphincter (UES) function and to investigate the effect of viscosity and other confounding factors on manometric results. Methods Manometric studies were performed on 26 asymptomatic volunteers (12 men and 14 women; age, 19–81 years). The manometric protocol included 5 water swallows (5 mL), 5 barium swallows (5 mL) and 5 yogurt swallows (5 mL). Evaluation of high-resolution manometry parameters including basal pressure of the UES, mesopharyngeal contractile integral (mesopharyngeal CI, mmHg · cm · sec), CI of the hypopharynx and UES (hypopharyngeal CI), relaxation interval of UES, median intrabolus pressure and nadir pressure at UES was performed using MATLAB. Results Mesopharyngeal CIs for barium and yogurt swallows were significantly lower than those for water swallows (both P < 0.05). Hypopharyngeal CIs for water swallows were significantly lower than those for barium swallows (P = 0.004), and median bolus pressure at UES for barium swallows was significantly higher than that for water and yogurt swallows (both P < 0.05). Furthermore, hypopharyngeal CI and median intrabolus pressure at UES were significantly related to age for 3 swallows (all P < 0.01 and P < 0.05, respectively). A significant negative correlation was also noted between nadir pressure at UES and age for water and yogurt swallows (all P < 0.05). Conclusions Manometric measurement of the pharynx and UES varies with respect to viscosity. Moreover, age could be a confounding variable in the interpretation of pharyngeal manometry. PMID:24847841

  14. Immunoglobulins from scleroderma patients inhibit the muscarinic receptor activation in internal anal sphincter smooth muscle cells

    PubMed Central

    Singh, Jagmohan; Mehendiratta, Vaibhav; Del Galdo, Francesco; Jimenez, Sergio A.; Cohen, Sidney; DiMarino, Anthony J.

    2009-01-01

    Systemic sclerosis (SSc) IgGs affecting the M3-muscarinic receptor (M3-R) have been proposed to be responsible for the gastrointestinal (GI) dysmotility in this disease. However, the effect of SSc IgGs on smooth muscle cell (SMC) function has not been studied. We determined the effect of SSc IgGs on the muscarinic receptor activation by bethanechol (BeCh; methyl derivate of carbachol) in SMC and smooth muscle strips from rat internal anal sphincter. IgGs were purified from GI-symptomatic SSc patients and normal volunteers, with protein G-Sepharose columns. SMC lengths were determined via computerized digital micrometry. The presence of M3-R and IgG-M3-R complex was determined by Western blot. IgGs from SSc patients but not from normal volunteers caused significant and concentration-dependent inhibition of BeCh response (P < 0.05). The maximal shortening of 22.2 ± 1.2% caused by 10?4 M BeCh was significantly attenuated to 8.3 ± 1.2% by 1 mg/ml of SSc IgGs (P < 0.05). Experiments performed in smooth muscle strips revealed a similar effect of SSc IgG that was fully reversible. In contrast to the effect on BeCh, the SSc IgGs caused no significant effect (P > 0.05) on K+ depolarization and ?1-adrenoceptor activation by phenylephrine. Western blot studies revealed the specific presence of SSc IgG-M3-R complex. SSc IgGs attenuated M3-R activation, which was reversible with antibody removal. These data suggest that SSc GI dysmotility may be caused by autoantibodies that inhibit the muscarinic neurotransmission. Future treatment of SSc patients may be directed at the removal or neutralization of these antibodies. PMID:19779020

  15. A novel point mutation of the androgen receptor (F804L) in an Egyptian newborn with complete androgen insensitivity associated with congenital glaucoma and hypertrophic pyloric stenosis.

    PubMed

    Gad, Y Z; Mazen, I; Lumbroso, S; Temtamy, S A; Sultan, C

    2003-01-01

    Androgen-insensitivity syndrome (AIS) is a major cause of male pseudohermaphroditism (MPH). Although AIS is usually reported as a monogenic disease resulting from androgen receptor (AR) mutations, on rare occasions it has been observed as part of a multiple congenital anomaly syndrome. We report here a patient who was the first newborn girl of an unrelated couple. Shortly after birth, the diagnoses of congenital glaucoma and pyloric stenosis were made. A detailed history of the father's family revealed that nine members presented glaucoma before 40 years of age. Clinical and ultrasound evaluation showed two inguinal testes, with female external genitalia and no Mullerian derivatives. The patient had a 46,XY karyotype, good testicular response to gonadotrophin stimulation and a remarkably high T : dihydrotestosterone ratio. Sequencing of the five exons of the 5alpha-reductase type 2 gene (SRD5A2) was normal. Conversely, a de novo point mutation was found in exon 6 of the AR gene, resulting in an F804L substitution, which has never been described previously. To our knowledge, the association of complete AIS, congenital glaucoma and pyloric stenosis has also never been reported previously. PMID:12519373

  16. A new reliable reference gene UBA52 for quantitative real-time polymerase chain reaction studies in pyloric cecal tissues of the starfish Asterias rubens.

    PubMed

    Sadritdinova, A F; Dmitriev, A A; Snezhkina, A V; Belenikin, M S; Krasnov, G S; Manylov, O G; Kudryavtsev, A A; Melnikova, N V; Speranskaya, A S; Darii, M V; Lakunina, V A; Uroshlev, L A; Smurov, A O; Stepanov, O A; Kudryavtseva, A V

    2014-01-01

    The starfish Asterias rubens is one of the most abundant echinoderm species in the White, Barents, North, and Baltic Seas. This species is an important component of marine ecosystems and a model object for certain biological studies, in particular those requiring quantitative estimation of gene expression. As a rule, expression at the transcriptional level is estimated by real-time qPCR using the ??Ct method, which allows the comparison of the copy number of target gene transcripts in samples with unknown mRNA/cDNA concentration. Application of this method requires normalization of the results relative to genes with stable expression levels (reference genes). The identification of reference genes is still a challenging task since data of this kind are missing for certain taxa, whereas the use of "standard" endogenous control genes without additional tests might lead to erroneous conclusions. We performed a preliminary analysis of the expression of many housekeeping genes in the pyloric ceca of A. rubens by high-throughput sequencing under normal and heat shock conditions. For one of them, the ubiquitin gene UBA52, low variation of expression (not greater than 2-fold) was shown using real-time qPCR. Tissues of pyloric ceca of normal adults and underyearlings and of adults after heat shock were used. The data obtained suggest that the UBA52 gene may be used as reference for normalization of gene expression at the mRNA level in the starfish A. rubens and probably in closely related species. PMID:24938608

  17. Use of macrolides in mother and child and risk of infantile hypertrophic pyloric stenosis: nationwide cohort study

    PubMed Central

    2014-01-01

    Objective To assess the association between use of macrolide antibiotics in mothers and infants from pregnancy onset until 120 days after birth and infantile hypertrophic pyloric stenosis (IHPS). Design Nationwide register based cohort study. Setting Denmark, 1996-2011. Participants 999?378 liveborn singletons and linked individual level information on macrolide prescriptions (maternal use during pregnancy, n=30?091; maternal use after birth, n=21?557; use in infants, n=6591), surgery for IHPS, and potential confounders. Main outcome measures Surgery for IHPS by three categories of macrolide use: in mothers during pregnancy, in mothers after birth, and in infants after birth. Results 880 infants developed IHPS (0.9 cases per 1000 births). Compared with infants with no use of macrolides, the adjusted rate ratio for IHPS in infants with use of macrolides during days 0 to 13 after birth was 29.8 (95% confidence interval 16.4 to 54.1) and during days 14 to 120 was 3.24 (1.20 to 8.74); the corresponding absolute risk differences were 24.4 (95% confidence interval 13.0 to 44.1) and 0.65 (0.06 to 2.21) cases per 1000 infants exposed to macrolides, respectively. The rate ratio for maternal use of macrolides for days 0 to 13 after birth was 3.49 (1.92 to 6.34) and for days 14 to 120 was 0.70 (0.26 to 1.90); the corresponding absolute risk differences were 2.15 (0.82 to 4.64) and ?0.11 (?0.26 to 0.31). The rate ratios for maternal use of macrolides during pregnancy were 1.02 (0.65 to 1.59) for weeks 0 to 27 and 1.77 (0.95 to 3.31) for weeks 28 to birth; the corresponding absolute risk differences were 0.01 (?0.31 to 0.50) and 0.67 (?0.06 to 2.02). Conclusions Treatment of young infants with macrolide antibiotics was strongly associated with IHPS and should therefore only be administered if potential treatment benefits outweigh the risk. Maternal use of macrolides during the first two weeks after birth was also associated with an increased risk of IHPS. A possible association was also found with use during late pregnancy. PMID:24618148

  18. A state-of-the-art review on the evolution of urinary sphincter devices for the treatment of post-prostatectomy urinary incontinence: past, present and future innovations.

    PubMed

    Chung, Eric

    2014-08-01

    An artificial urinary sphincter (AUS) is the only mechanical device that closely simulates the function of a biological urinary sphincter. Over the past four decades, advances in mechanical design, applications of new technology and lessons learned from clinical experience have made AMS 800 device the standard of care in post-prostatectomy urinary incontinence. While the current AMS 800 device provides an effective, safe and durable option, it is not without its limitations and complications. Newer and innovative AUS-like devices are designed to rectify some of AMS 800 device problems, but, like any mechanical device, they too have their own shortcomings. Emerging novel therapies such as nanotechnology-driven device and stem cell therapy are attractive, but are not commercially available or have no proven long-term outcome. The following article provides a critical review on the past, present and future innovations in designing the ideal urinary sphincter to treat post-prostatectomy urinary incontinence. PMID:24936961

  19. The Dysfunctions of Bureaucratic Structure.

    ERIC Educational Resources Information Center

    Duttweiler, Patricia Cloud

    1988-01-01

    Numerous dysfunctions result from bureaucratic school organization, including an overemphasis on specialized tasks, routine operating rules, and formal procedures for managing teaching and learning. Such schools are characterized by numerous regulations; formal communications; centralized decision making; and sharp distinctions among…

  20. Causes of sexual dysfunction (image)

    MedlinePLUS

    Female sexual dysfunction describes women who are indifferent or hostile to sexual intercourse, who have no response to sexual advances or stimulation, or who are unable to have an orgasm during sexual intercourse.

  1. Cardiovascular Implications of Erectile Dysfunction

    MedlinePLUS

    ... Institution: NIH Library User Name Password Sign In Cardiology Patient Page Cardiovascular Implications of Erectile Dysfunction Bryan ... PDF Free PPT Slides of All Figures Classifications Cardiology Patient Page Services Article Usage Statistics E-mail ...

  2. Investigation of intra-esophageal air kinetics and esophageal sphincters in patients with total laryngectomy during esophageal speech.

    PubMed

    Bozan, Aykut; Vardar, Rukiye; Akyildiz, Serdar; Kirazli, Tayfun; Ogut, Fatih; Yildirim, Esra; Bor, Serhat

    2015-08-01

    The purpose of this study was to evaluate the air kinetics of well- and poor-speaking patients and their upper (UES) and lower (LES) esophageal sphincter pressures . The esophageal speech capability of 23 total laryngectomy patients was assessed with the Wepman scale. LES and UES points and pressures were measured, and air kinetics were compared. All patients were male, with an average age of 58 years. Both the LES and UES pressures were not statistically different between good-speaking and poor-speaking patients (p > 0.05). The ability to speak was estimated only by looking at tracings. Good speakers are able to retain air successfully and on a long-term basis between the upper and lower esophageal sphincters. During short and/or rapid speech, these patients are able to rapidly suck and then expel the air from their upper esophagus. During long speeches, after sucking the air into their distal esophagus, they used the air in the upper part of the esophagus during the speech, only later seeming to fill the lower esophagus with the air as a possible reserve in the stomach. It has been shown that the basic requirement for speaking is the capacity to suck and store the air within the esophagus. For successful speech, the air should be stored inside the esophagus. MII technology contributes to our understanding of speech kinetics and occupies an important place in patient training as a biofeedback technique. PMID:25763572

  3. Argon Plasma Coagulation Therapy Versus Topical Formalin for Intractable Rectal Bleeding and Anorectal Dysfunction After Radiation Therapy for Prostate Carcinoma

    SciTech Connect

    Yeoh, Eric, E-mail: eric.yeoh@health.sa.gov.au [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia); School of Medicine, University of Adelaide, Adelaide (Australia); Tam, William; Schoeman, Mark [School of Medicine, University of Adelaide, Adelaide (Australia); Department of Gastroenterology, Royal Adelaide Hospital, Adelaide (Australia); Moore, James; Thomas, Michelle [School of Medicine, University of Adelaide, Adelaide (Australia); Department of Colorectal Surgery, Royal Adelaide Hospital, Adelaide (Australia); Botten, Rochelle; Di Matteo, Addolorata [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia)

    2013-12-01

    Purpose: To evaluate and compare the effect of argon plasma coagulation (APC) and topical formalin for intractable rectal bleeding and anorectal dysfunction associated with chronic radiation proctitis. Methods and Materials: Thirty men (median age, 72 years; range, 49-87 years) with intractable rectal bleeding (defined as ?1× per week and/or requiring blood transfusions) after radiation therapy for prostate carcinoma were randomized to treatment with APC (n=17) or topical formalin (n=13). Each patient underwent evaluations of (1) anorectal symptoms (validated questionnaires, including modified Late Effects in Normal Tissues–Subjective, Objective, Management, and Analytic and visual analogue scales for rectal bleeding); (2) anorectal motor and sensory function (manometry and graded rectal balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before and after the treatment endpoint (defined as reduction in rectal bleeding to 1× per month or better, reduction in visual analogue scales to ?25 mm, and no longer needing blood transfusions). Results: The treatment endpoint was achieved in 94% of the APC group and 100% of the topical formalin group after a median (range) of 2 (1-5) sessions of either treatment. After a follow-up duration of 111 (29-170) months, only 1 patient in each group needed further treatment. Reductions in rectal compliance and volumes of sensory perception occurred after APC, but no effect on anorectal symptoms other than rectal bleeding was observed. There were no differences between APC and topical formalin for anorectal symptoms and function, nor for anal sphincteric morphology. Conclusions: Argon plasma coagulation and topical formalin had comparable efficacy in the durable control of rectal bleeding associated with chronic radiation proctitis but had no beneficial effect on anorectal dysfunction.

  4. Swallowing dysfunction after critical illness.

    PubMed

    Macht, Madison; White, S David; Moss, Marc

    2014-12-01

    Critical care practitioners must frequently make decisions about their patients' ability to swallow food, liquids, and pills. These decisions can be particularly difficult given the incompletely defined epidemiology, diagnostic criteria, and prognostic features of swallowing disorders in critically ill patients. Furthermore, the consequences of improper decisions-namely, aspiration, malnutrition, hunger, and thirst-can be devastating to patients and their families. This review outlines the problem of swallowing dysfunction in critically ill patients and then addresses the most clinically relevant questions that critical care practitioners face today. First, we review the epidemiology of swallowing dysfunction in critically ill patients. Next, we describe the different diagnostic tests for swallowing dysfunction and describe a general approach to the initial assessment for swallowing disorders. Finally, we explore the existing treatments for swallowing dysfunction. Given the burden of swallowing dysfunction in patients recovering from critical illness, enabling critical care practitioners to manage these disorders, while stimulating new investigation into their pathophysiology, diagnosis, and management, will enhance our care of critically ill patients. PMID:25451355

  5. Erectile dysfunction in aging male.

    PubMed

    Romanelli, Francesco; Sansone, Andrea; Lenzi, Andrea

    2010-01-01

    With the increasing longevity in men and women, sexual health concerns have become more and more important and demands for help are far more common than in the past. Erectile dysfunction's severity and prevalence both increase with aging: since erectile dysfunction is a symptom, physicians should diagnose underlying pathologies that might lead to it instead of focusing on finding a viable treatment. Cardiovascular alterations occur in the elderly, and might lead to erectile dysfunction because of penile blood flow impairment: diabetes, smoking, and sedentary life-style, being risk factors for vascular pathologies, can affect erectile function. Metabolic syndrome and psychological factors are highly prevalent in aging men, and might be other important determinants of erectile dysfunction. Drugs play a role in the pathogenesis of erectile dysfunction, as they can alter hormonal or vascular mechanics needed for achieving or maintaining erection. Alterations in penile vessels can be observed in the elderly: lack of androgens might lead to a reduction of smooth muscle cells content in the penis and an increase in the caliber of vascular spaces. Hypogonadism, when present, should be treated regardless of age; furthermore, synergistic effects have been found during testosterone replacement therapy when using an oral therapy with a PDE-5 inhibitor (sildenafil, vardenafil or tadalafil). These therapies are effective in the elderly, with no increase in the frequency of adverse events, and might also help in providing relief from lower urinary tract symptoms. PMID:20518197

  6. Functional and quality-of-life outcomes in patients with rectal cancer after combined modality therapy, intraoperative radiation therapy, and sphincter preservation

    Microsoft Academic Search

    David Shibata; Jose G. Guillem; Nicole Lanouette; Phillip Paty; Bruce Minsky; Louis Harrison; W. Douglas Wong; Alfred Cohen

    2000-01-01

    PURPOSE: Locally advanced primary and recurrent rectal cancers treated with external beam radiation therapy, intraoperative radiation therapy, and chemotherapy represent a complex group of patients in the setting of extensive pelvic surgery and sphincter preservation. We sought to define functional outcome and quality of life in this subset of patients. METHODS: We retrospectively reviewed our experience with locally advanced primary

  7. Dose-Response Relations for Anal Sphincter Regarding Fecal Leakage and Blood or Phlegm in Stools after Radiotherapy for Prostate Cancer

    Microsoft Academic Search

    Panayiotis Mavroidis; Massoud al-Abany; Ásgeir R. Helgason; Anna-Karin Ågren Cronqvist; Peter Wersäll; Helena Lind; Eva Qvanta; Kyriaki Theodorou; Constantin Kappas; Bengt K. Lind; Gunnar Steineck; Anders Brahme

    2005-01-01

    Background: The estimation of the parameters that describe the dose-response relations of anal sphincter regarding the clinical endpoints of fecal leakage and blood or phlegm in stools is important in the optimization of prostate cancer radiotherapy. Also, the validity of the relative seriality model for this clinical case needs to be examined by associating the clinical follow-up results with the

  8. Delivery through perineal body and severed external anal sphincter with an intact vaginal orifice during a precipitous labor: a case report

    PubMed Central

    Ismail, Khadijah Irfah; McDonnell, Brendan; O'Coigligh, Seosamh

    2015-01-01

    Key Clinical Message We present the case of a patient who delivered her baby through the perineal body with an intact vaginal introitus. Damage to the perineal body through its connection to the external anal sphincter can involve the rectovaginal septum with increased morbidity and thought to be linked to rectocele development. PMID:25984315

  9. 2D DIGE Does Not Reveal all: A Scotopic Report Suggests Differential Expression of a Single “Calponin Family Member” Protein for Tetany of Sphincters!

    PubMed Central

    Chaudhury, Arun

    2015-01-01

    Using 2D differential gel electrophoresis (DIGE) and mass spectrometry (MS), a recent report by Rattan and Ali (2015) compared proteome expression between tonically contracted sphincteric smooth muscles of the internal anal sphincter (IAS), in comparison to the adjacent rectum [rectal smooth muscles (RSM)] that contracts in a phasic fashion. The study showed the differential expression of a single 23?kDa protein SM22, which was 1.87 fold, overexpressed in RSM in comparison to IAS. Earlier studies have shown differences in expression of different proteins like Rho-associated protein kinase II, myosin light chain kinase, myosin phosphatase, and protein kinase C between IAS and RSM. The currently employed methods, despite its high-throughput potential, failed to identify these well-characterized differences between phasic and tonic muscles. This calls into question the fidelity and validatory potential of the otherwise powerful technology of 2D DIGE/MS. These discrepancies, when redressed in future studies, will evolve this recent report as an important baseline study of “sphincter proteome.” Proteomics techniques are currently underutilized in examining pathophysiology of hypertensive/hypotensive disorders involving gastrointestinal sphincters, including achalasia, gastroesophageal reflux disease (GERD), spastic pylorus, seen during diabetes or chronic chemotherapy, intestinal pseudo-obstruction, and recto-anal incontinence. Global proteome mapping may provide instant snapshot of the complete repertoire of differential proteins, thus expediting to identify the molecular pathology of gastrointestinal motility disorders currently labeled “idiopathic” and facilitating practice of precision medicine. PMID:26151053

  10. Developmental pathways of motor dysfunction.

    PubMed

    Kleven, Gale A; Bellinger, Seanceray A

    2015-05-01

    Recent evidence has revealed unique patterns of behavioral development after prenatal insult similar to those outlined in studies of adult metabolic dysfunction after prenatal malnutrition. The hallmark features of this Developmental Pathway include a prenatal insult to the nervous system (environmental or genetic) followed by a period of Silent Vulnerability, where no or few functional deficits are observed, and finally emergence of later dysfunction. Possible mechanisms leading to later dysfunction from prenatal insult may include secondary or cascade effects due to the timing of prenatal insults relative to later developing structures in the brain. Methods best employed to study the mechanisms of these pathways are microgenetic and longitudinal designs that include behavioral assessment during the prenatal period of development, and animal models such as the guinea pig. © 2015 Wiley Periodicals, Inc. Dev Psychobiol 57: 435-446, 2015. PMID:25864561

  11. Obesity and pelvic floor dysfunction.

    PubMed

    Ramalingam, Kalaivani; Monga, Ash

    2015-05-01

    Obesity is associated with a high prevalence of pelvic floor disorders. Patients with obesity present with a range of urinary, bowel and sexual dysfunction problems as well as uterovaginal prolapse. Urinary incontinence, faecal incontinence and sexual dysfunction are more prevalent in patients with obesity. Uterovaginal prolapse is also more common than in the non-obese population. Weight loss by surgical and non-surgical methods plays a major role in the improvement of these symptoms in such patients. The treatment of symptoms leads to an improvement in their quality of life. However, surgical treatment of these symptoms may be accompanied by an increased risk of complications in obese patients. A better understanding of the mechanism of obesity-associated pelvic floor dysfunction is essential. PMID:25805440

  12. [Sexual dysfunctions in selected endocrinopathies].

    PubMed

    Skrzypulec, Violetta; Nowosielski, Krzysztof; Drosdzol, Agnieszka; Kowalaczyk, Robert

    2005-01-01

    According to the socio-sexological reports approximately 40-45% of women and up to 30% of males may suffer from different sexual dysfunctions. The prevalence of those disorders is gradually increasing with age. Multiply numbers of endocrinopathies may influence the human sexual life. In diabetic patients all phases of the sexual responses cycle, especially orgasm, might be affected. Women diagnosed with PCOS have decreased adaptation to the sexual life, low self-esteem and perception of self sexual attractiveness. The intimacy of infertile couples has not been well described and the characteristic of particular dysfunction in sex life has not been established yet. Interdisciplinary approach, understood as treatment of the endocrinopathy accompanied with psychological and sexological counseling, seems to be the fundamental issue in the therapy of sexual dysfunctions in patients with endocrinological disorders. PMID:16821220

  13. Does stress induce bowel dysfunction?

    PubMed

    Chang, Yu-Ming; El-Zaatari, Mohamad; Kao, John Y

    2014-08-01

    Psychological stress is known to induce somatic symptoms. Classically, many gut physiological responses to stress are mediated by the hypothalamus-pituitary-adrenal axis. There is, however, a growing body of evidence of stress-induced corticotrophin-releasing factor (CRF) release causing bowel dysfunction through multiple pathways, either through the HPA axis, the autonomic nervous systems, or directly on the bowel itself. In addition, recent findings of CRF influencing the composition of gut microbiota lend support for the use of probiotics, antibiotics, and other microbiota-altering agents as potential therapeutic measures in stress-induced bowel dysfunction. PMID:24881644

  14. Bioengineering of Physiologically Functional Intrinsically Innervated Human Internal Anal Sphincter Constructs

    PubMed Central

    Gilmont, Robert R.; Raghavan, Shreya; Somara, Sita

    2014-01-01

    Muscle replacement for patients suffering from extensive tissue loss or dysfunction is a major objective of regenerative medicine. To achieve functional status, bioengineered muscle replacement constructs require innervation. Here we describe a method to bioengineer functionally innervated gut smooth muscle constructs using neuronal progenitor cells and smooth muscle cells isolated and cultured from intestinal tissues of adult human donors. These constructs expressed markers for contractile smooth muscle, glial cells, and mature neuronal populations. The constructs responded appropriately to physiologically relevant neurotransmitters, and neural network integration was demonstrated by responses to electrical field stimulation. The ability of enteric neuroprogenitor cells to differentiate into neuronal populations provides enormous potential for functional innervation of a variety of bioengineered muscle constructs in addition to gut. Functionally innervated muscle constructs offer a regenerative medicine-based therapeutic approach for neuromuscular replacement after trauma or degenerative disorders. PMID:24328537

  15. Clinical evaluation of a single daily dose of phenylpropanolamine in the treatment of urethral sphincter mechanism incompetence in the bitch

    PubMed Central

    Claeys, Stéphanie; Rustichelli, Frederico; Noël, Stéphanie; Hamaide, Annick

    2011-01-01

    The objective of this retrospective study was to determine the efficacy of a single daily oral dose of phenylpropanolamine (PPA) in the treatment of urethral sphincter mechanism incompetence (USMI) in bitches. Nine bitches diagnosed with USMI were treated with a single daily dose [1.5 mg/kg body weight (BW)] of PPA for at least 1 month. Urethral pressure profiles (UPP) were performed in 7 dogs before treatment and repeated in 4 of them after treatment. Treatment with PPA resulted in long-term continence in 8/9 bitches. One dog did not respond to PPA and was treated surgically later. Recheck UPPs showed a significant increase in maximal urethral closure pressure in the 4 bitches after treatment with PPA compared to before treatment. In conclusion, long-term continence can be achieved in bitches affected with USMI after administration of a single daily dose of PPA (1.5 mg/kg BW). PMID:22043069

  16. Modulation of Tau Dysfunction In Vitro

    E-print Network

    Voss, Kellen

    2011-05-31

    on tau to prevent its dysfunction. This dissertation explores how phosphorylation with GSK-3?, the major kinase believed to be involved in tau hyperphosphorylation, and interactions with Hsp70, affect tau dysfunction (polymerization) and function...

  17. GABAergic dysfunction in mood disorders

    Microsoft Academic Search

    P Brambilla; J Perez; F Barale; G Schettini; J C Soares

    2003-01-01

    The authors review the available literature on the preclinical and clinical studies involving GABAergic neurotransmission in mood disorders. ?-Aminobutyric acid (GABA) is an inhibitory neurotransmitter present almost exclusively in the central nervous system (CNS), distributed across almost all brain regions, and expressed in interneurons modulating local circuits. The role of GABAergic dysfunction in mood disorders was first proposed 20 years

  18. Chemotherapy-associated renal dysfunction

    Microsoft Academic Search

    Vaibhav Sahni; Devasmita Choudhury; Ziauddin Ahmed

    2009-01-01

    The presence of renal dysfunction in a patient receiving chemotherapy can be devastating. Although many patients with cancer have underlying compromised renal function, some chemotherapeutic agents can actually induce renal abnormalities. An understanding of which traditional and newer chemotherapy agents can affect renal function is useful for physicians so that they can monitor patients for renal abnormalities and initiate preventive

  19. Astroglial Dysfunction in Hepatic Encephalopathy

    Microsoft Academic Search

    Michael D. Norenberg

    1998-01-01

    While the pathogenesis of hepatic encephalopathy (HE) remains elusive, there is considerable evidence pointing to a key role of ammonia-induced dysfunction of astrocytes in this condition. Deficits in the ability of astrocytes to take up glutamate from the extracellular space may lead to abnormal glutamatergic neurotransmission. Furthermore, excessive stimulation of neuronal and glial glutamate receptors by elevated extracellular levels of

  20. Does Uremia Cause Vascular Dysfunction?

    Microsoft Academic Search

    Philippe Brunet; Bertrand Gondouin; Ariane Duval-Sabatier; Laetitia Dou; Claire Cerini; Françoise Dignat-George; Noémie Jourde-Chiche; Angel Argiles; Stéphane Burtey

    2011-01-01

    Vascular dysfunction induced by uremia has 4 main aspects. (1) Atherosclerosis is increased. Intima-media thickness is increased, and animal studies have established that uremia accelerates atherosclerosis. Uremic toxins are involved in several steps of atherosclerosis. Leukocyte activation is stimulated by guanidines, advanced glycation end products (AGE), p-cresyl sulfate, platelet diadenosine polyphosphates, and indoxyl sulfate. Endothelial adhesion molecules are stimulated by

  1. Tachykinin receptors mediating responses to sensory nerve stimulation and exogenous tachykinins and analogues in the rabbit isolated iris sphincter.

    PubMed Central

    Hall, J. M.; Mitchell, D.; Morton, I. K.

    1993-01-01

    1. We have used selective tachykinin receptor agonists and antagonists to investigate the nature of the receptors mediating responses to endogenous and exogenous tachykinins in the rabbit iris sphincter preparation in vitro. 2. The NK1-selective agonist, substance P methyl ester, induced contraction with a pD2 of 9.16 indicating the presence of NK1 receptors. In confirmation, the NK1-selective antagonist, GR82334, competitively antagonized responses to substance P methyl ester with high affinity (pKB 7.46). 3. NK3 receptors also mediate contraction since NK3-selective agonists exhibited high potency, e.g. the pD2 of [Me-Phe7]-neurokinin B was 9.67, and their responses were not inhibited by GR82334 (10 microM). 4. NK2 receptor activation does not seem to contribute to contraction since the NK2-selective agonist [beta-Ala8]-neurokinin A(4-10) had relatively low potency (pD2 6.43), and the NK2-selective antagonists MEN10207 (1 microM) and L-659,877 (10 microM) were inactive or had low affinity, respectively. 5. GR82334 (1 microM) significantly inhibited responses to electrical field-stimulation of non-adrenergic non-cholinergic sensory nerves (3, 10 and 30 Hz), and caused a rightward shift of the log concentration-response curve to bradykinin (lateral shift ca. 1000 fold). Higher concentrations of GR82334 (10 microM) significantly attenuated responses to capsaicin (1-60 microM) whilst completely abolishing responses to field-stimulation (3, 10 and 30 Hz) and bradykinin (1 nM- 3 microM). 6. In conclusion, NK1 and NK3 receptor activation results in contraction of the rabbit iris sphincter. The contractile response following sensory nerve stimulation by bradykinin, capsaicin and electrical field stimulation results from NK1 receptor activation. PMID:8401912

  2. Use of anti-inflammatory drugs and lower esophageal sphincter relaxing drugs and risk of esophageal and gastric cancers

    PubMed Central

    Fortuny, Joan; Johnson, Christine; Bohlke, Kari; Chow, Wong-Ho; Hart, Gene; Kucera, Gena; Mujumdar, Urvi; Ownby, Dennis; Wells, Karen; Yood, Marianne Ulcickas; Engel, Lawrence S.

    2007-01-01

    Background and aims The incidence of esophageal and gastric cardia adenocarcinoma has increased in western countries in recent decades for largely unknown reasons. We investigated whether use of lower esophageal sphincter (LES) relaxing drugs was related to an increased risk of esophageal and gastric cardia adenocarcinoma, and whether use of non-steroidal anti-inflammatory drugs was related to a reduced risk of esophageal and gastric cancers. Methods We examined these associations using administrative databases in a case-control study in two integrated health care delivery systems. Cases were incident esophageal adenocarcinomas (n= 163) and squamous cell carcinomas (n= 114), and gastric cardia (n= 176) and non-cardia adenocarcinomas (n= 320), diagnosed between 1980 and 2002 in one health system and between 1993 and 2002 in the other. Matched controls (n= 3996) were selected. Complete prescription information was available for the study period. Results Prescription of corticosteroids was associated with a decreased risk of esophageal adenocarcinoma (OR= 0.6, 95% CI= 0.4-0.9), esophageal squamous cell carcinoma (OR= 0.4, 95% CI= 0.2-0.6) and gastric non-cardia carcinoma (OR= 0.4, 95% CI=0.3-0.6). Ever use of pharmacy-purchased aspirin was associated with 30-60% decreased risks of the studied cancers. As a group, LES-relaxing drugs showed little evidence of association with increased risk of any esophageal or gastric cancer. Conclusions Corticosteroid and aspirin use were associated with significantly decreased risks of esophageal and gastric cancer. Lower esophageal sphincter relaxing drugs as a group did not affect these risks, although we had limited power to assess individual drugs. The possibility that corticosteroids and aspirin may reduce esophageal cancer risk warrants further consideration. PMID:17644046

  3. Molecular and pharmacological characterization of a functional tachykinin NK3 receptor cloned from the rabbit iris sphincter muscle

    PubMed Central

    Medhurst, Andrew D; Hirst, Warren D; Jerman, Jeffery C; Meakin, Jacqueline; Roberts, Jennifer C; Testa, Tania; Smart, Darren

    1999-01-01

    A functional tachykinin NK3 receptor was cloned from the rabbit iris sphincter muscle and its distribution investigated in ocular tissues.Standard polymerase chain reaction (PCR) techniques were used to clone a full length rabbit NK3 receptor cDNA consisting of 1404 nucleotides. This cDNA encoded a protein of 467 amino acids with 91 and 87% homology to the human and rat NK3 receptors respectively.In CHO-K1 cells transiently expressing the recombinant rabbit NK3 receptor, the relative order of potency of NKB>>NKA?SP to displace [125I]-[MePhe7]-NKB binding and to increase intracellular calcium, together with the high affinity of NK3 selective agonists (e.g. senktide, [MePhe7]-NKB) and antagonists (e.g. SR?142801, SB?223412) in both assays was consistent with NK3 receptor pharmacology. In binding and functional experiments, agonist concentration response curves were shallow (0.7–0.8), suggesting the possibility of multiple affinity states of the receptor.Quantitative real time PCR analysis revealed highest expression of rabbit NK3 receptor mRNA in iris sphincter muscle, lower expression in retina and iris dilator muscle, and no expression in lens and cornea. In situ hybridization histochemistry revealed discrete specific localization of NK3 receptor mRNA in the iris muscle and associated ciliary processes. Discrete specific labelling of NK3 receptors with the selective NK3 receptor agonist [125I]-[MePhe7]-NKB was also observed in the ciliary processes using autoradiography.Our study reveals a high molecular similarity between rabbit and human NK3 receptor mRNAs, as predicted from previous pharmacological studies, and provide the first evidence that NK3 receptors are precisely located on ciliary processes in the rabbit eye. In addition, there could be two affinity states of the receptor which may correspond to the typical and ‘atypical' NK3 receptor subtypes previously reported. PMID:10516642

  4. Nitinol Stents for Palliative Treatment of Malignant Obstructive Jaundice: Should We Stent the Sphincter of Oddi in Every Case?

    SciTech Connect

    Hatzidakis, Adam A.; Tsetis, Dimitris; Chrysou, Evangelia [Department of Radiology, University Hospital Heraklion, Medical School of Crete, 71500 Heraklion-Stavrakia, Crete (Greece); Sanidas, Elias [Clinic for Surgical Oncology, University Hospital Heraklion, Medical School of Crete, 71500 Heraklion, Crete (Greece); Petrakis, John [Clinic for General Surgery, University Hospital Heraklion, Medical School of Crete, 71500 Heraklion, Crete (Greece); Gourtsoyiannis, Nicholas C. [Department of Radiology, University Hospital Heraklion, Medical School of Crete, 71500 Heraklion-Stavrakia, Crete (Greece)

    2001-07-15

    Purpose: To evaluate the necessity of metallic stenting of the sphincter of Oddi in malignant obstructive jaundice when the tumor is more than 2 cm from the papilla of Vater.Methods: Sixty-seven self-expandable biliary stents were used in 60 patients with extrahepatic lesions of the common hepatic or common bile duct and with the distal margin of the tumor located more than 2 cm from the papilla of Vater. Stents were placed above the papilla in 30 cases (group A) and in another 30 with their distal part protruding into the duodenum (group B).Results: The 30-day mortality was 15%, due to the underlying disease. The stent occlusion rate was 17% after a mean period of 4.3 months. No major complications were noted. Average survival was 132 days for group A and 140 days for group B. In group A, 19 patients survived {<=} 90 days and in eight of these, cholangitis occurred at least once. Of 11 patients in group A with survival > 90 days, only two developed cholangitis. In group B, 13 patients who survived {<=} 90 days had no episodes of cholangitis and in 17 with survival > 90 days, cholangitis occurred in three. There is a statistically significant difference (p < 0.05) regarding the incidence of cholangitis in favor of group A.Conclusions: In patients with extrahepatic lesions more than 2 cm from the papilla and with a relative poor prognosis ({<=} 3 months), due to more advanced disease or to a worse general condition, the sphincter of Oddi should also be stented in order to reduce the postprocedural morbidity.

  5. A psychological profile of the sexual dysfunctions

    Microsoft Academic Search

    Leonard R. Derogatis; Jon K. Meyer

    1979-01-01

    The present report summarizes an assessment of the psychological characteristics of a sample of sexually dysfunctional patients and compares them to those of a sample of heterosexual normals. Forty-seven male and 40 female dysfunctional patients were evaluated on the Derogatis Sexual Functioning Inventory (DSFI) and contrasted to a group of 200 heterosexual normals. Findings indicated substantial differences between dysfunctionals and

  6. Erectile dysfunction in patients with cardiovascular disease

    PubMed Central

    Ophuis, A.J.M. Oude; Nijeholt, A.A.B. Lycklama à

    2006-01-01

    Erectile dysfunction is a highly prevalent disease, especially in cardiovascular-compromised men. Many of the well-established risk factors for cardiovascular disease are also risk factors for erectile dysfunction. A correlation between erectile dysfunction and endothelial dysfunction is well established. It is postulated that erectile dysfunction with an arteriovascular aetiology can predate and be an indicator of potential coronary artery disease. In this paper we will attempt to increase awareness among cardiologists for the predictive value of erectile dysfunction for future cardiovascular disease in order to optimise cardiovascular risk management. The treatment of erectile dysfunction and cardiovascular interactions is also discussed in detail. ImagesFigure 1AFigure 1B PMID:25696612

  7. Mitochondria: Redox Metabolism and Dysfunction

    PubMed Central

    Kang, Jia; Pervaiz, Shazib

    2012-01-01

    Mitochondria are the main intracellular location for fuel generation; however, they are not just power plants but involved in a range of other intracellular functions including regulation of redox homeostasis and cell fate. Dysfunction of mitochondria will result in oxidative stress which is one of the underlying causal factors for a variety of diseases including neurodegenerative diseases, diabetes, cardiovascular diseases, and cancer. In this paper, generation of reactive oxygen/nitrogen species (ROS/RNS) in the mitochondria, redox regulatory roles of certain mitochondrial proteins, and the impact on cell fate will be discussed. The current state of our understanding in mitochondrial dysfunction in pathological states and how we could target them for therapeutic purpose will also be briefly reviewed. PMID:22593827

  8. Endothelial dysfunction in pulmonary hypertension

    Microsoft Academic Search

    Dominique Yelle; Lakshmi Kugathasan; Robin E. MacLaren; Duncan J. Stewart

    \\u000a Pulmonary arterial hypertension (PAH) is a rare disease caused by functional and structural abnormalities in distal pulmonary\\u000a arterioles that result in progressive increases in pulmonary vascular resistance, often leading to right heart failure and\\u000a death. Endothelial dysfunction, defined as a shift in the balance of production of endothelial vasodilator factors (i.e.,\\u000a nitric oxide and prostacyclin), and vasoconstrictor and proliferative factors

  9. Insulin dysfunction and Tau pathology

    PubMed Central

    El Khoury, Noura B.; Gratuze, Maud; Papon, Marie-Amélie; Bretteville, Alexis; Planel, Emmanuel

    2013-01-01

    The neuropathological hallmarks of Alzheimer's disease (AD) include senile plaques of ?-amyloid (A?) peptides (a cleavage product of the Amyloid Precursor Protein, or APP) and neurofibrillary tangles (NFT) of hyperphosphorylated Tau protein assembled in paired helical filaments (PHF). NFT pathology is important since it correlates with the degree of cognitive impairment in AD. Only a small proportion of AD is due to genetic variants, whereas the large majority of cases (~99%) is late onset and sporadic in origin. The cause of sporadic AD is likely to be multifactorial, with external factors interacting with biological or genetic susceptibilities to accelerate the manifestation of the disease. Insulin dysfunction, manifested by diabetes mellitus (DM) might be such factor, as there is extensive data from epidemiological studies suggesting that DM is associated with an increased relative risk for AD. Type 1 diabetes (T1DM) and type 2 diabetes (T2DM) are known to affect multiple cognitive functions in patients. In this context, understanding the effects of diabetes on Tau pathogenesis is important since Tau pathology show a strong relationship to dementia in AD, and to memory loss in normal aging and mild cognitive impairment. Here, we reviewed preclinical studies that link insulin dysfunction to Tau protein pathogenesis, one of the major pathological hallmarks of AD. We found more than 30 studies reporting Tau phosphorylation in a mouse or rat model of insulin dysfunction. We also payed attention to potential sources of artifacts, such as hypothermia and anesthesia, that were demonstrated to results in Tau hyperphosphorylation and could major confounding experimental factors. We found that very few studies reported the temperature of the animals, and only a handful did not use anesthesia. Overall, most published studies showed that insulin dysfunction can promote Tau hyperphosphorylation and pathology, both directly and indirectly, through hypothermia. PMID:24574966

  10. Vascular Surgery for Erectile Dysfunction

    Microsoft Academic Search

    William O. Brant; Anthony J. Bella; Maurice M. Garcia; Tom F. Lue

    Erectile dysfunction (ED) is common and potentially devastating. Men often complain that although the various modalities of\\u000a treatment are potentially effective, they are not “natural” because they require assistance from a pill, injection, or device\\u000a and do not allow for the same level of spontaneity that was previously enjoyed. Rather than symptom management, men desire\\u000a a cure. With the exception

  11. Mitochondrial dysfunction and organophosphorus compounds

    SciTech Connect

    Karami-Mohajeri, Somayyeh [Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Kerman University of Medical Sciences, Kerman (Iran, Islamic Republic of); Abdollahi, Mohammad, E-mail: Mohammad.Abdollahi@UToronto.Ca [Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of)

    2013-07-01

    Organophosphorous (OPs) pesticides are the most widely used pesticides in the agriculture and home. However, many acute or chronic poisoning reports about OPs have been published in the recent years. Mitochondria as a site of cellular oxygen consumption and energy production can be a target for OPs poisoning as a non-cholinergic mechanism of toxicity of OPs. In the present review, we have reviewed and criticized all the evidences about the mitochondrial dysfunctions as a mechanism of toxicity of OPs. For this purpose, all biochemical, molecular, and morphological data were retrieved from various studies. Some toxicities of OPs are arisen from dysfunction of mitochondrial oxidative phosphorylation through alteration of complexes I, II, III, IV and V activities and disruption of mitochondrial membrane. Reductions of adenosine triphosphate (ATP) synthesis or induction of its hydrolysis can impair the cellular energy. The OPs disrupt cellular and mitochondrial antioxidant defense, reactive oxygen species generation, and calcium uptake and promote oxidative and genotoxic damage triggering cell death via cytochrome C released from mitochondria and consequent activation of caspases. The mitochondrial dysfunction induced by OPs can be restored by use of antioxidants such as vitamin E and C, alpha-tocopherol, electron donors, and through increasing the cytosolic ATP level. However, to elucidate many aspect of mitochondrial toxicity of Ops, further studies should be performed. - Highlights: • As a non-cholinergic mechanism of toxicity, mitochondria is a target for OPs. • OPs affect action of complexes I, II, III, IV and V in the mitochondria. • OPs reduce mitochondrial ATP. • OPs promote oxidative and genotoxic damage via release of cytochrome C from mitochondria. • OP-induced mitochondrial dysfunction can be restored by increasing the cytosolic ATP.

  12. Progress in Female Sexual Dysfunction

    Microsoft Academic Search

    Fatma Ferda Verit; Ercan Yeni; Hasan Kafali

    2006-01-01

    Introduction: Female sexual dysfunction (FSD) is a significant age-related, progressive and highly prevalent problem that affects a substantial number of women that causes personal distress and has negative effects on quality of life and interpersonal relationships. Definitions: The female sexual response cycle consists of three phases: desire, arousal, and orgasm, and is initiated by non-adrenergic\\/non-cholinergic, e.g. vasoactive intestinal polypeptide and

  13. [Endothelial dysfunction and arterial hypertension].

    PubMed

    Marecková, Z; Heller, S; Horký, K

    1999-04-01

    The endothelium lines all blood vessels in the human body, it is the basic structure which ensures the action of substances circulating in the blood stream on the vascular wall. It is an organ the sound state of which is essential for the physiological function of the vascular system. Its impaired function is a basic factor in the genesis and development of vascular disease. Under physiological conditions the endothelium has antiadhesive and antithrombotic properties, it produces vasoactive substances, prevents the penetration of circulating substances and formed elements across the vascular wall, and via adhesion molecules it participates in the interaction with cells in the circulation. Risk factors of cardiovascular diseases such as hypertension, hyperlipidaemia, hyperglycaemia, smoking damage the function of endothelial cells and cause the development of endothelial dysfunction. In patients with arterial hypertension endothelial dysfunction is characterized by an impaired endothelium dependent relaxation, increased adhesion and permeability of endothelial cells, structural changes of the vascular wall. When the endothelium is damaged by released cytokines an increased expression of adhesion molecules occurs, adhesion and migration of inflammatory cells across the vascular wall. Cytoadhesion molecules are released from the surface of the endothelium into the circulation where the rise of their plasma levels can serve as a marker of endothelial damage. Endothelial dysfunction in hypertonic subjects contributes in a significant way to the development and progression of chronic vascular disease--atherosclerosis. Improvement of the damaged endothelial function is therefore at present a desirable therapeutic objective in the treatment of hypertension. PMID:11045186

  14. Tension-Free Vaginal Tape (TVT) in Stress Incontinent Women with Intrinsic Sphincter Deficiency (ISD) - A Long-Term Follow-up

    Microsoft Academic Search

    M. Rezapour; C. Falconer; U. Ulmsten

    2001-01-01

    In a prospective long-term study 49 women with stress incontinence and ISD (intrinsic sphincter deficiency) were followed for a mean of 4 years (range 3-5) after TVT operation. Preoperatively all patients underwent urodynamic investigations, quality of life evaluation, a 24-hour pad test and a gynecologic examination to properly verify the incontinence symptoms. The same protocol was used for postoperative evaluation.

  15. Increased motor unit fibre density in the external anal sphincter muscle in ano-rectal incontinence: a single fibre EMG study

    Microsoft Academic Search

    M E Neill; M Swash

    1980-01-01

    The motor unit fibre density in the external anal sphincter muscle has been measured in 13 normal subjects aged 18 to 78 years, and in 14 patients with ano-rectal incontinence, aged 17 to 72 years. The mean fibre density in the normal subjects was 1.5 +\\/- 0.16, and in the incontinent subjects it was 2.17 +\\/- 0.28 (p less than

  16. Effects of Age, Gender, Bolus Condition, Viscosity, and Volume on Pharyngeal and Upper Esophageal Sphincter Pressure and Temporal Measurements during Swallowing

    ERIC Educational Resources Information Center

    Butler, Susan G.; Stuart, Andrew; Castell, Donald; Russell, Gregory B.; Koch, Kenneth; Kemp, Shannon

    2009-01-01

    Purpose: The purpose of this study was to determine the effects of trial (i.e., Trial 1 vs. Trial 2); viscosity (i.e., saliva, thin, nectar-thick, honey-thick, and pudding-thick water); volume (i.e., 5 mL vs. 10 mL); age (i.e., young vs. older adults); and gender on pharyngeal (i.e., upper and lower) and upper esophageal sphincter (UES) pressures,…

  17. Pharmacotherapy of Sexual Dysfunctions : Current Status

    PubMed Central

    Avasthi, Ajith; Biswas, Parthasarathy

    2004-01-01

    The sexual dysfunctions are one of the most prevalent conditions. Sexual dysfunctions can have profound effect on the psychological well-being of an individual and the psychosexual relationship of a couple. Management of the sexual dysfunction should be preceded by an accurate diagnosis reached after a complete medical and sexual history and physical examination. Current focus of researchers has been on understanding the pathophysiology of erectile dysfunction, premature ejaculation and other sexual dysfunctions that can help in developing newer pharmacological cures for these conditions. Recently, a number of clinical trials have studied the potential effectiveness of the phosphodiesterase (PDE)-5 inhibitor sildenafil in the treatment of Erectile Dysfunction (ED) and Premature Ejaculation (PME). The introduction of PDE-5 inhibitors like sildenafil, vardenafil and tadalafil has revolutionized the treatment of sexual dysfunctions. This review focuses on the recent pharmacological advances in the treatment of common sexual dysfunctions like ED and PME with special focus on the role of PDE-5 inhibitors. Also discussed is the pharmacological treatment of other less prevalent and recognized disorders like female sexual dysfunction, drug induced sexual dysfunction etc. PMID:21224902

  18. Quantifying Contributions of the Cricopharyngeus to Upper Esophageal Sphincter Pressure Changes by Means of Intramuscular Electromyography and High-Resolution Manometry

    PubMed Central

    Jones, Corinne A.; Hammer, Michael J.; Hoffman, Matthew R.; McCulloch, Timothy M.

    2014-01-01

    Objectives We sought to determine whether the association between cricopharyngeus muscle activity and upper esophageal sphincter pressure may change in a task-dependent fashion. We hypothesized that more automated tasks related to swallow or airway protection would yield a stronger association than would more volitional tasks related to tidal breathing or voice production. Methods Six healthy adult subjects underwent simultaneous intramuscular electromyography of the cricopharyngeus muscle and high-resolution manometry of the upper esophageal sphincter. Correlation coefficients were calculated to characterize the association between the time-linked series. Results Cricopharyngeus muscle activity was most strongly associated with upper esophageal sphincter pressure during swallow and effortful exhalation tasks (r = 0.77 and 0.79, respectively; P < .01). The association was also less variable during swallow and effortful exhalation. Conclusions These findings suggest a greater coupling for the more automatic tasks, and may suggest less coupling and more flexibility for the more volitional, voice-related tasks. These findings support the important role of central patterning for respiratory- and swallow-related tasks. PMID:24633943

  19. Effects of pinaverium bromide in the premedication of endoscopic retrograde cholangio-pancreatography and on motor activity of the sphincter of Oddi.

    PubMed

    Lamazza, A; Tofi, A; Bolognese, A; Fontana, B; De Masi, E; Frontespezi, S

    1986-01-01

    A double-blind study was carried out in 18 patients with biliary and pancreatic disease to assess the use of pinaverium bromide in premedication for endoscopic retrograde cholangio-pancreatography and its effects on motor activity of the sphincter of Oddi. Patients were divided at random into three groups. One group received 100 mg pinaverium bromide twice daily for 3 days before and then 100 mg 1 hour before the examination, the second group received placebo, and the third had no medication. All patients received 10 to 20 mg diazepam intravenously 10 minutes before endoscopy. Assessments were made of the transit time of various endoscopic phases and patients' tolerance of the procedure. The effects of treatment on the sphincter of Oddi were estimated by means of endoscopic manometry. The results showed that pinaverium bromide allowed transit time reduction in endoscopic procedure, a greater tolerance on the part of the patient and marked reduction in the amplitude and duration of the phasic activity of the sphincter. PMID:3780291

  20. Dosimetric Coverage of the External Anal Sphincter by 3-Dimensional Conformal Fields in Rectal Cancer Patients Receiving Neoadjuvant Chemoradiation: Implications for the Concept of Sphincter-Preserving Radiation Therapy

    PubMed Central

    Chen, Michelle B.; Liu, Alan J.; Tsai, Peter

    2014-01-01

    Background. We evaluated the anatomic location of the external anal sphincter (EAS) to pelvic bony landmarks related to 3-dimensional conformal radiotherapy (3DRT) and studied the dosimetric coverage of the EAS in patients undergoing neoadjuvant chemoradiation for rectal cancer. Methods. Sixty-four consecutive rectal cancer patients treated with neoadjuvant chemoradiation were included. All patients were treated in a prone position on a bellyboard by 3DRT. The inferior border of the RT fields was at least 3–5?cm inferior to the gross tumorous volume (GTV) or at the inferior border of the obturator foramen (IBOF), whichever was more inferior. The EAS was contoured and dose distributions were determined using dose-volume histograms. Results. In 53 out of 64 cases (82.8%), the EAS was completely inferior to the IBOF. In the remaining 11 cases, the EAS was either overlapping the IBOF (10 cases; 15.6%) or completely superior to the IBOF (1 case; 1.7%). The average mean dose delivered to the EAS was 2795?cGy. Lower mean doses were delivered to the EAS when the center of the EAS was located more distant from the GTV. Conclusions. Meticulous planning to define the inferior border of the RT field is recommended to avoid irradiating the EAS. PMID:25089274

  1. Alkaloids from Mahonia bealei posses anti-H?/K?-ATPase and anti-gastrin effects on pyloric ligation-induced gastric ulcer in rats.

    PubMed

    Zhang, Su-Li; Li, Hui; He, Xin; Zhang, Run-Qi; Sun, Yu-He; Zhang, Chun-Feng; Wang, Chong-Zhi; Yuan, Chun-Su

    2014-09-25

    The purpose of this study was to investigate the underlying mechanism(s) of the total alkaloids (TA) from Mahonia bealei in treating pyloric ligation-induced gastric ulcers in rats. Animals were sacrificed after 19 h of the ligation. Gastric acid, peptic activities, mucin levels, H(+)/K(+)-ATPase activities and the gastrin level were analyzed. To improve the accuracy of the observations, IPP 6.0 software was introduced to measure the area of ulcer. TA (18.56 mg/kg/day, i.g.) showed an antiulcer effect by significantly decreasing the gastric ulcer areas (11.28 mm(2)) compared with model group (26.36 mm(2)). The TA ulcer inhibition ratio was 57.2%, compared with the effect of the positive control, omeprazole (62.96%). The results also showed that TA had a significant effect in inhibiting the release of H(+)/K(+)-ATPase, reducing the content of gastrin and decreasing gastric acidity on experimental animals. However, the TA had no significant effects on gastric mucus secretion and pepsin activity. Data indicated that TA had gastric ulcer protective effects by modulating the H(+)/K(+)-ATPase activity and gastrin level. TA has a potential to be developed as a pharmacological agent for the treatment of gastric ulcers. PMID:25172799

  2. Genome-wide High-Density SNP-Based Linkage Analysis of Infantile Hypertrophic Pyloric Stenosis Identifies Loci on Chromosomes 11q14-q22 and Xq23

    PubMed Central

    Everett, Kate V.; Chioza, Barry A.; Georgoula, Christina; Reece, Ashley; Capon, Francesca; Parker, Keith A.; Cord-Udy, Cathy; McKeigue, Paul; Mitton, Sally; Pierro, Agostino; Puri, Prem; Mitchison, Hannah M.; Chung, Eddie M.K.; Gardiner, R. Mark

    2008-01-01

    Infantile hypertrophic pyloric stenosis (IHPS) has an incidence of 1–8 per 1000 live births and is inherited as a complex sex-modified multifactorial trait with a striking male preponderance. Syndromic and monogenic forms exist, and two loci have been identified. Infants present with vomiting due to gastric-outlet obstruction caused by hypertrophy of the smooth muscle of the pylorus. A genome-wide SNP-based high-density linkage scan was carried out on 81 IHPS pedigrees. Nonparametric and parametric linkage analysis identified loci on chromosomes 11q14-q22 (Zmax = 3.9, p < 0.0001; HLODmax = 3.4, ? = 0.34) and Xq23 (Zmax = 4.3, p < 0.00001; HLODmax = 4.8, ? = 0.56). The two linked chromosomal regions each harbor functional candidate genes that are members of the canonical transient receptor potential (TRPC) family of ion channels and have a potential role in smooth-muscle control and hypertrophy. PMID:18308288

  3. Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction

    PubMed Central

    Johnson, E. U.; Singh, Gurpreet

    2013-01-01

    The advent of specialized spinal units and better understanding of the pathophysiology of neurogenic urinary tract dysfunction has made long-term survival of these patients a reality. This has, in turn, led to an increase in quality and choice of management modalities offered to these patients including complex anatomic urinary tract reconstructive procedures tailored to the unique needs of each individual with variable outcomes. We performed a literature review evaluating the long-term outcomes of these reconstructive procedures. To achieve this, we conducted a world-wide electronic literature search of long-term outcomes published in English. As the premise of this review is long-term outcomes, we have focused on pathologies where evidence of long-term outcome is available such as patients with spinal injuries and spina bifida. Therapeutic success following urinary tract reconstruction is usually measured by preservation of renal function, improvement in quality-of-life, the satisfactory achievement of agreed outcomes and the prevention of serious complications. Prognostic factors include neuropathic detrusor overactivity; sphincter dyssynergia; bladder over distension; high pressure storage and high leak point pressures; vesicoureteric reflex, stone formation and urinary tract infections. Although, the past decade has witnessed a reduction in the total number of bladder reconstructive surgeries in the UK, these procedures are essentially safe and effective; but require long-term clinical and functional follow-up/monitoring. Until tissue engineering and gene therapy becomes more mainstream, we feel there is still a place for urinary tract reconstruction in patients with neurogenic lower urinary tract dysfunction. PMID:24235796

  4. Mitochondrial Dysfunction in Parkinson's Disease.

    PubMed

    Moon, Hyo Eun; Paek, Sun Ha

    2015-06-01

    Parkinson's disease (PD) is characterized by the selective loss of dopaminergic neurons of the substantia nigra pars compacta (SNc) with motor and nonmotor symptoms. Defective mitochondrial function and increased oxidative stress (OS) have been demonstrated as having an important role in PD pathogenesis, although the underlying mechanism is not clear. The etiopathogenesis of sporadic PD is complex with variable contributions of environmental factors and genetic susceptibility. Both these factors influence various mitochondrial aspects, including their life cycle, bioenergetic capacity, quality control, dynamic changes of morphology and connectivity (fusion, fission), subcellular distribution (transport), and the regulation of cell death pathways. Mitochondrial dysfunction has mainly been reported in various non-dopaminergic cells and tissue samples from human patients as well as transgenic mouse and fruit fly models of PD. Thus, the mitochondria represent a highly promising target for the development of PD biomarkers. However, the limited amount of dopaminergic neurons prevented investigation of their detailed study. For the first time, we established human telomerase reverse transcriptase (hTERT)-immortalized wild type, idiopathic and Parkin deficient mesenchymal stromal cells (MSCs) isolated from the adipose tissues of PD patients, which could be used as a good cellular model to evaluate mitochondrial dysfunction for the better understanding of PD pathology and for the development of early diagnostic markers and effective therapy targets of PD. In this review, we examine evidence for the roles of mitochondrial dysfunction and increased OS in the neuronal loss that leads to PD and discuss how this knowledge further improve the treatment for patients with PD. PMID:26113789

  5. Mitochondrial Dysfunction in Parkinson's Disease

    PubMed Central

    Moon, Hyo Eun

    2015-01-01

    Parkinson's disease (PD) is characterized by the selective loss of dopaminergic neurons of the substantia nigra pars compacta (SNc) with motor and nonmotor symptoms. Defective mitochondrial function and increased oxidative stress (OS) have been demonstrated as having an important role in PD pathogenesis, although the underlying mechanism is not clear. The etiopathogenesis of sporadic PD is complex with variable contributions of environmental factors and genetic susceptibility. Both these factors influence various mitochondrial aspects, including their life cycle, bioenergetic capacity, quality control, dynamic changes of morphology and connectivity (fusion, fission), subcellular distribution (transport), and the regulation of cell death pathways. Mitochondrial dysfunction has mainly been reported in various non-dopaminergic cells and tissue samples from human patients as well as transgenic mouse and fruit fly models of PD. Thus, the mitochondria represent a highly promising target for the development of PD biomarkers. However, the limited amount of dopaminergic neurons prevented investigation of their detailed study. For the first time, we established human telomerase reverse transcriptase (hTERT)-immortalized wild type, idiopathic and Parkin deficient mesenchymal stromal cells (MSCs) isolated from the adipose tissues of PD patients, which could be used as a good cellular model to evaluate mitochondrial dysfunction for the better understanding of PD pathology and for the development of early diagnostic markers and effective therapy targets of PD. In this review, we examine evidence for the roles of mitochondrial dysfunction and increased OS in the neuronal loss that leads to PD and discuss how this knowledge further improve the treatment for patients with PD.

  6. Significance of feeding dysfunction in eosinophilic esophagitis

    PubMed Central

    Menard-Katcher, Calies; Henry, Michelle; Furuta, Glenn T; Atkins, Dan; Maune, Nancy Creskoff; Haas, Angela M

    2014-01-01

    Feeding dysfunction is a frequent presenting symptom of eosinophilic esophagitis (EoE). Here we present 3 children of various ages whose manifestations of EoE associated feeding dysfunction led to significant and life altering impact on their growth and development. Early identification of presenting symptoms of EoE will allow for prompt diagnosis and initiation of appropriate treatments. Recognition of salient features of dysfunction and treatment by feeding therapists and nutritionists led to symptom resolution and growth. PMID:25152606

  7. Neuromotor dysfunction in early psychosis.

    PubMed

    Whitehorn, David; Kopala, Lili C

    2002-06-01

    Neuromotor dysfunction, particularly extrapyramidal signs and symptoms (EPSS), plays an important role in the assessment and treatment of patients in the early stages of psychotic disorders such as schizophrenia. By blocking dopamine D2 receptors, antipsychotic medications can produce EPSS, including tardive dyskinesia. EPSS is also observed in a third or more of patients first presenting with a psychotic disorder, prior to initiation of antipsychotic pharmacotherapy. This suggests that abnormalities in neuromotor control may be an integral component of the brain mechanisms associated with psychosis. Atypical antipsychotic agents can alleviate psychosis without inducing EPSS. Preexisting EPSS may be corrected. PMID:12238736

  8. Male sexual dysfunction in Asia

    PubMed Central

    Ho, Christopher CK; Singam, Praveen; Hong, Goh Eng; Zainuddin, Zulkifli Md

    2011-01-01

    Sex has always been a taboo subject in Asian society. However, over the past few years, awareness in the field of men's sexual health has improved, and interest in sexual health research has recently increased. The epidemiology and prevalence of erectile dysfunction, hypogonadism and premature ejaculation in Asia are similar in the West. However, several issues are specific to Asian males, including culture and beliefs, awareness, compliance and the availability of traditional/complementary medicine. In Asia, sexual medicine is still in its infancy, and a concerted effort from the government, relevant societies, physicians and the media is required to propel sexual medicine to the forefront of health care. PMID:21643001

  9. Endothelial dysfunction: a comprehensive appraisal

    PubMed Central

    Esper, Ricardo J; Nordaby, Roberto A; Vilariño, Jorge O; Paragano, Antonio; Cacharrón, José L; Machado, Rogelio A

    2006-01-01

    The endothelium is a thin monocelular layer that covers all the inner surface of the blood vessels, separating the circulating blood from the tissues. It is not an inactive organ, quite the opposite. It works as a receptor-efector organ and responds to each physical or chemical stimulus with the release of the correct substance with which it may maintain vasomotor balance and vascular-tissue homeostasis. It has the property of producing, independently, both agonistic and antagonistic substances that help to keep homeostasis and its function is not only autocrine, but also paracrine and endocrine. In this way it modulates the vascular smooth muscle cells producing relaxation or contraction, and therefore vasodilatation or vasoconstriction. The endothelium regulating homeostasis by controlling the production of prothrombotic and antithrombotic components, and fibrynolitics and antifibrynolitics. Also intervenes in cell proliferation and migration, in leukocyte adhesion and activation and in immunological and inflammatory processes. Cardiovascular risk factors cause oxidative stress that alters the endothelial cells capacity and leads to the so called endothelial "dysfunction" reducing its capacity to maintain homeostasis and leads to the development of pathological inflammatory processes and vascular disease. There are different techniques to evaluate the endothelium functional capacity, that depend on the amount of NO produced and the vasodilatation effect. The percentage of vasodilatation with respect to the basal value represents the endothelial functional capacity. Taking into account that shear stress is one of the most important stimulants for the synthesis and release of NO, the non-invasive technique most often used is the transient flow-modulate "endothelium-dependent" post-ischemic vasodilatation, performed on conductance arteries such as the brachial, radial or femoral arteries. This vasodilatation is compared with the vasodilatation produced by drugs that are NO donors, such as nitroglycerine, called "endothelium independent". The vasodilatation is quantified by measuring the arterial diameter with high resolution ultrasonography. Laser-Doppler techniques are now starting to be used that also consider tissue perfusion. There is so much proof about endothelial dysfunction that it is reasonable to believe that there is diagnostic and prognostic value in its evaluation for the late outcome. There is no doubt that endothelial dysfunction contributes to the initiation and progression of atherosclerotic disease and could be considered an independent vascular risk factor. Although prolonged randomized clinical trials are needed for unequivocal evidence, the data already obtained allows the methods of evaluation of endothelial dysfunction to be considered useful in clinical practice and have overcome the experimental step, being non-invasive increases its value making it use full for follow-up of the progression of the disease and the effects of different treatments. PMID:16504104

  10. Cerebrovascular Dysfunction in Preeclamptic Pregnancies.

    PubMed

    Hammer, Erica Shields; Cipolla, Marilyn J

    2015-08-01

    Preeclampsia is a hypertensive, multisystem disorder of pregnancy that affects several organ systems, including the maternal brain. Cerebrovascular dysfunction during preeclampsia can lead to cerebral edema, seizures, stroke, and potentially maternal mortality. This review will discuss the effects of preeclampsia on the cerebrovasculature that may adversely affect the maternal brain, including cerebral blood flow (CBF) autoregulation and blood-brain barrier disruption and the resultant clinical outcomes including posterior reversible encephalopathy syndrome (PRES) and maternal stroke. Potential long-term cognitive outcomes of preeclampsia and the role of the cerebrovasculature are also reviewed. PMID:26126779

  11. New evidence on the mechanisms underlying bradykinin-mediated contraction of the pig iris sphincter in vitro.

    PubMed

    El Sayah, Mariem; Calixto, João B

    2003-07-01

    We have reported previously that bradykinin (BK) induces potent and reproducible concentration-dependent contractions of the pig iris sphincter (PIS) muscle in vitro through the activation of BK B(2) receptors. Here we attempted to investigate additional mechanisms by which BK induces contraction of the PIS in vitro. BK-mediated contraction of the PIS relied largely on the external Ca2+ influx by a mechanism sensitive to the L-, N- and P-type of Ca2+ channel selective blockers. Likewise, BK-induced contraction of the PIS was greatly inhibited by the CGRP-(8-37), NK(2) or NK(3) receptor antagonists (SR 48968, SR 142801), and to a lesser extent by the NK(1) antagonist (FK 888). Capsaicin desensitization of PIS or capsazepine pre-incubation also significantly reduced BK-mediated contraction in the PIS. Furthermore, KT 5720 or GF 109203X (the protein kinase A and C inhibitors, respectively) also significantly inhibited BK-mediated contraction. Taken together, these results indicate that BK-mediated contraction of the PIS seems to be mediated primarily by the release of CGRP and tachykinins from sensory nerve fibers, and relies largely on extracellular Ca2+ influx via activation of L-, N- and P-type of Ca2+ channels. Finally, these responses are mediated by activation of both protein kinase A- and C-dependent mechanisms. PMID:14499283

  12. Introduction: New Developments in the Area of Sexual Dysfunction(s)

    Microsoft Academic Search

    Richard Balon

    2008-01-01

    New developments in the area of sexual dysfunction, e.g. epidemiology and pharmacological treatment, are reviewed. Areas where new developments\\/changes are needed, such as diagnosis of sexual dysfunction and research methodology, are also briefly discussed.

  13. Diabetes and sexual dysfunction: current perspectives

    PubMed Central

    Maiorino, Maria Ida; Bellastella, Giuseppe; Esposito, Katherine

    2014-01-01

    Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes. PMID:24623985

  14. Astroglial dysfunction in hepatic encephalopathy.

    PubMed

    Norenberg, M D

    1998-12-01

    While the pathogenesis of hepatic encephalopathy (HE) remains elusive, there is considerable evidence pointing to a key role of ammonia-induced dysfunction of astrocytes in this condition. Deficits in the ability of astrocytes to take up glutamate from the extracellular space may lead to abnormal glutamatergic neurotransmission. Furthermore, excessive stimulation of neuronal and glial glutamate receptors by elevated extracellular levels of glutamate may lead to excitotoxicity and greater glial dysfunction. Ammonia also causes upregulation of astroglial peripheral-type benzodiazepine receptors (PBRs) which is associated with increased production of neurosteroids. These neurosteroids have potent positive modulatory effects on the neuronal GABA(A) receptor which, combined with an ammonia-induced astroglial defect in GABA uptake, may result in enhanced GABAergic tone. Brain edema, associated with fulminant hepatic failure, may also result from astroglial abnormalities as the edema appears to be principally caused by swelling of these cells. Increased amounts of glutamine in astrocytes resulting from elevated brain ammonia levels may be a factor in this swelling. Other osmolytes such as glutathione may also be involved. Glial swelling may also result from NH4+ - and K+ -mediated membrane depolarization as well as by the actions of PBR agonists and neurosteroids. These findings show that an ammonia-induced gliopathy is a major factor in the pathogenesis of HE. PMID:10206824

  15. Endothelial progenitor cell dysfunction in rheumatic disease

    Microsoft Academic Search

    Marianne C. Verhaar; Peter E. Westerweel

    2009-01-01

    Rheumatic disease is characterized by inflammation and endothelial dysfunction, which contribute to accelerated atherosclerosis. Circulating endothelial progenitor cells (EPCs) can restore dysfunctional endothelium and thereby protect against atherosclerotic vascular disease. The number and function of EPCs are, however, affected in rheumatic diseases such as psoriatic arthritis, rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and antineutrophil cytoplasmic autoantibody-associated vasculitis. Rheumatic disease

  16. Urinary dysfunction in Parkinson's disease: A review

    Microsoft Academic Search

    Helen Blackett; Richard Walker; Brian Wood

    2009-01-01

    Urinary dysfunction, primarily in the form of detrusor overactivity, is highly prevalent amongst individuals with idiopathic Parkinson's disease (IPD). There has been increasing realisation of the importance of this and other non-motor features of the condition. The presentation of, pathophysiology behind and management options for bladder dysfunction in IPD are discussed.

  17. Psychosocial Dysfunction in Adults with Epilepsy.

    ERIC Educational Resources Information Center

    Pershad, Dwarka; Siddiqui, Razia S.

    1992-01-01

    This study examined the amount of psychosocial disturbance experienced by adults (n=53) in India with epilepsy, as well as the relationship between psychosocial dysfunction, duration of illness, and computerized axial tomography findings. Results indicated that three-quarters exhibited no or very mild psychosocial dysfunction. (DB)

  18. Urinary dysfunction in Parkinson's disease: A review

    Microsoft Academic Search

    Helen Blackett; Richard Walker; Brian Wood

    2009-01-01

    Urinary dysfunction, primarily in the form of detrusor overactivity, is highly prevalent amongst individuals with idiopathic Parkinson's disease (IPD). There has been increasing realisation of the importance of this and other non-motor features of the condition. The presentation of, pathophysiology behind and management options for bladder dysfunction in IPD are discussed. Crown Copyright 2008 Published by Elsevier Ltd. All rights

  19. Vascular dysfunction in idiopathic dilated cardiomyopathy

    Microsoft Academic Search

    Santiago Roura; Antoni Bayes-Genis

    2009-01-01

    Idiopathic dilated cardiomyopathy (IDCM) is defined as myocardial dilatation and dysfunction in the absence of overt coronary heart disease. Myocardial injury and genetic or environmental factors can lead to the development of IDCM, which was historically characterized by marked abnormalities in the function and integrity of cardiomyocytes. However, cardiac endothelial dysfunction has also been shown to be associated with progression

  20. Mitochondrial dysfunction affecting visual pathways.

    PubMed

    Leruez, S; Amati-Bonneau, P; Verny, C; Reynier, P; Procaccio, V; Bonneau, D; Milea, D

    2014-05-01

    Mitochondrial dysfunction leads to cellular energetic impairment, which may affect the visual pathways, from the retina to retrochiasmal structures. The most common mitochondrial optic neuropathies include Leber's hereditary optic neuropathy and autosomal dominant optic atrophy, but the optic nerve can be affected in other syndromic conditions, such as Wolfram syndrome and Friedreich's ataxia. These disorders may result from mutations in either the mitochondrial DNA or in the nuclear genes encoding mitochondrial proteins. Despite the inconstant genotype-phenotype correlations, a clinical classification of mitochondrial disorders may be made on the basis of distinct neuro-ophthalmic presentations such as optic neuropathy, pigmentary retinopathy and retrochiasmal visual loss. Although no curative treatments are available at present, recent advances throw new light on the pathophysiology of mitochondrial disorders. Current research raises hopes for novel treatment of hereditary optic neuropathies, particularly through the use of new drugs and mitochondrial gene therapy. PMID:24798923

  1. [Thyroid dysfunction in the elderly].

    PubMed

    Mikkelsen, K V; Andersen-Ranberg, K; Hegedüs, L

    2001-05-14

    In the elderly, thyroid dysfunction usually develops insidiously and is dominated by non-specific symptoms and clinical findings, typically related to normal aging or to age-associated disease. Case finding, in combination with a low threshold for biochemical control, is recommended. In Denmark, hyperthyroidism is more frequent than hypothyroidism. Subclinical hyperthyroidism is generally temporary. In subclinical hypothyroidism the annual progression rate to manifest hypothyroidism is 2-3%, but higher (5-10%) in the presence of thyroid autoantibodies. Treatment recommendation is related to the serum level of thyroid stimulating hormone and the presence of thyroid peroxidase autoantibodies. Hypothyroidism should be treated with lower doses of thyroxine, and the titration phase is longer. An antithyroid drug is the initial treatment in hyperthyroidism, often followed by radioiodine therapy. In Denmark, radioiodine therapy of nontoxic goitre has become more common. PMID:11374211

  2. Noradrenergic dysfunction in Alzheimer's disease

    PubMed Central

    Gannon, Mary; Che, Pulin; Chen, Yunjia; Jiao, Kai; Roberson, Erik D.; Wang, Qin

    2015-01-01

    The brain noradrenergic system supplies the neurotransmitter norepinephrine throughout the brain via widespread efferent projections, and plays a pivotal role in modulating cognitive activities in the cortex. Profound noradrenergic degeneration in Alzheimer's disease (AD) patients has been observed for decades, with recent research suggesting that the locus coeruleus (where noradrenergic neurons are mainly located) is a predominant site where AD-related pathology begins. Mounting evidence indicates that the loss of noradrenergic innervation greatly exacerbates AD pathogenesis and progression, although the precise roles of noradrenergic components in AD pathogenesis remain unclear. The aim of this review is to summarize current findings on noradrenergic dysfunction in AD, as well as to point out deficiencies in our knowledge where more research is needed. PMID:26136654

  3. [Biliary dysfunction in obese children].

    PubMed

    Aleshina, E I; Gubonina, I V; Novikova, V P; Vigurskaia, M Iu

    2014-01-01

    To examine the state of the biliary system, a study of properties of bile "case-control") 100 children and adolescents aged 8 to 18 years, held checkup in consultative and diagnostic center for chronic gastroduodenitis. BMI children were divided into 2 groups: group 1-60 children with obesity (BMI of 30 to 40) and group 2-40 children with normal anthropometric indices. Survey methods included clinical examination pediatrician, endocrinologist, biochemical parameters (ALT, AST, alkaline phosphatase level, total protein, bilirubin, lipidogram, glucose, insulin, HOMA-index), ultrasound of the abdomen and retroperitoneum, EGD with aspiration of gallbladder bile. Crystallography bile produced by crystallization of biological substrates micromethods modification Prima AV, 1992. Obese children with chronic gastroduodenita more likely than children of normal weight, had complaints and objective laboratory and instrumental evidence of insulin resistance and motor disorders of the upper gastrointestinal and biliary tract, liver enlargement and biliary "sludge". Biochemical parameters of obese children indicate initial metabolic changes in carbohydrate and fat metabolism and cholestasis, as compared to control children. Colloidal properties of bile in obese children with chronic gastroduodenita reduced, as indicated by the nature of the crystallographic pattern. Conclusions: Obese children with chronic gastroduodenitis often identified enlarged liver, cholestasis and biliary dysfunction, including with the presence of sludge in the gallbladder; most often--hypertonic bile dysfunction. Biochemical features of carbohydrate and fat metabolism reflect the features of the metabolic profile of obese children. Crystallography bile in obese children reveals the instability of the colloidal structure of bile, predisposing children to biliary sludge, which is a risk factor for gallstones. PMID:25911906

  4. Proper Development of the Outer Longitudinal Smooth Muscle of the Mouse Pylorus Requires Nkx2-5 and Gata3

    PubMed Central

    Saenz, David A.; Schinke, Martina; Moriguchi, Takashi; Jay, Patrick Y.; Lim, Kim-Chew; Engel, James Douglas; Gumucio, Deborah L.

    2014-01-01

    Background & Aims Infantile hypertrophic pyloric stenosis (IHPS) is a common birth anomaly characterized by obstruction of the pyloric lumen. A genome-wide association study implicated NKX2-5, which encodes a transcription factor that is expressed in embryonic heart and pylorus, in the pathogenesis of IHPS. However, the function of the NKX2-5 in pyloric smooth muscle development has not been directly examined. We investigated the pattern of Nkx2-5 during the course of murine pyloric sphincter development and examined co-expression of Nkx2-5 with Gata3 and Sox9—other transcription factors with pyloric-specific mesenchymal expression. We also assessed pyloric sphincter development in mice with disruption of Nkx2-5 or Gata3. Methods We used immunofluorescence analysis to compare levels of NKX2-5, GATA3, and SOX9 in different regions of smooth muscle cells. Pyloric development was assessed in mice with conditional or germline deletion of Nkx2-5 or Gata3, respectively. Results Gata3, Nkx2-5, and Sox9 were co-expressed in differentiating smooth muscle cells of a distinct fascicle of the pyloric outer longitudinal muscle (OLM). Expansion of this fascicle coincided with development of the pyloric sphincter. Disruption of Nkx2-5 or Gata3 caused severe hypoplasia of this fascicle and alters pyloric muscle shape. Although expression of Sox9 required Nkx2-5 and Gata3, there was no apparent hierarchical relationship between Nkx2-5 and Gata3 during pyloric OLM development. Conclusions Nkx2-5 and Gata3 are independently required for the development of a pyloric OLM fascicle, which required for pyloric sphincter morphogenesis, in mice. These data indicate that regulatory changes that alter Nkx2-5 or Gata3 expression could contribute to pathogenesis of IHPS. PMID:24120474

  5. Metabolic Dysfunction in Diabetic Cardiomyopathy

    PubMed Central

    Isfort, Michael; Stevens, Sarah C.W.; Schaffer, Stephen; Jong, Chian Ju; Wold, Loren E.

    2013-01-01

    Diabetic cardiomyopathy (DCM) is defined as cardiac disease independent of vascular complications during diabetes. The number of new cases of DCM is rising at epidemic rates in proportion to newly diagnosed cases of diabetes mellitus (DM) throughout the world. DCM is a heart failure syndrome found in diabetic patients that is characterized by left ventricular hypertrophy and reduced diastolic function, with or without concurrent systolic dysfunction, occurring in the absence of hypertension and coronary artery disease. DCM and other diabetic complications are caused in part by elevations in blood glucose and lipids, characteristic of DM. Although there are pathological consequences to hyperglycemia and hyperlipidemia, the combination of the two metabolic abnormalities potentiates the severity of diabetic complications. A natural competition exists between glucose and fatty acid metabolism in the heart that is regulated by allosteric and feedback control and transcriptional modulation of key limiting enzymes. Inhibition of these glycolytic enzymes not only controls flux of substrate through the glycolytic pathway, but also leads to the diversion of glycolytic intermediate substrate through pathological pathways, which mediate the onset of diabetic complications. The present review describes the limiting steps involved in the development of these pathological pathways and the factors involved in the regulation of these limiting steps. Additionally, therapeutic options with demonstrated or postulated effects on DCM are described. PMID:23443849

  6. Metabolic Syndrome and Erectile Dysfunction

    PubMed Central

    Schipilliti, Mirko; Caretta, Nicola; Palego, Pierfrancesco; Selice, Riccardo; Ferlin, Alberto; Foresta, Carlo

    2011-01-01

    OBJECTIVE To study the relation between metabolic syndrome (MS), cavernosal morphological vasculopathy, and peripheral vascular alterations (carotid and femoral wall) in patients with erectile dysfunction. RESEARCH DESIGN AND METHODS A total of 207 patients and 50 control subjects were evaluated for cardiovascular risk factors, physical examination, reproductive hormones, ultrasound analysis of cavernosal, carotid and femoral arteries (intima-media thickness), and cavernosal flow measurement (peak systolic velocity). RESULTS A total of 28% of patients had MS, and they presented with a high prevalence of cavernosal alterations (70.3%) and systemic vascular impairment (59.3%), whereas patients with cavernosal alterations (44%) showed the higher prevalence of MS (48.9%). The number of MS components was related to the prevalence of penile vasculopathy. However, multivariate analysis showed that MS is not an independent predictor for cavernosal vasculopathy. CONCLUSIONS Patients with cavernosal vasculopathy have an increased cardiometabolic risk, and screening for MS components might identify individuals with a higher risk for cavernosal and systemic atherosclerosis. PMID:21730283

  7. An analysis of survival and treatment failure following abdominoperineal and sphincter-saving resection in Dukes' B and C rectal carcinoma. A report of the NSABP clinical trials. National Surgical Adjuvant Breast and Bowel Project.

    PubMed Central

    Wolmark, N; Fisher, B

    1986-01-01

    Abdominoperineal resections for rectal carcinoma are being performed with decreasing frequency in favor of sphincter-saving resections. It remains, however, to be unequivocally demonstrated that sphincter preservation has not resulted in compromised local disease control, disease-free survival, and survival. Accordingly, it is the specific aim of this endeavor to compare local recurrence, disease-free survival, and survival in patients with Dukes' B and C rectal cancer undergoing curative abdominoperineal resection or sphincter-saving resection. For the purpose of this study, 232 patients undergoing abdominoperineal resection and 181 subjected to sphincter-saving resections were available for analysis from an NSABP randomized prospective clinical trial designed to ascertain the efficacy of adjuvant therapy in rectal carcinoma (protocol R-01). The mean time on study was 48 months. Analyses were carried out comparing the two operations according to Dukes' class, the number of positive nodes, and tumor size. The only significant differences in disease-free survival and survival were observed for the cohort characterized by greater than 4 positive nodes and were in favor of patients treated with sphincter-saving resections. A patient undergoing sphincter-saving resection was 0.62 times as likely to sustain a treatment failure as a similar patient undergoing abdominoperineal resection (p = 0.07) and 0.49 times as likely to die (p = 0.02). The inability to demonstrate an attenuated disease-free survival and survival for patients treated with sphincter-saving resection was in spite of an increased incidence of local recurrence (anastomotic and pelvic) observed for the latter operation when compared to abdominoperineal resection (13% vs. 5%). A similar analysis evaluating the length of margins of resection in patients undergoing sphincter-preserving operations indicated that treatment failure and survival were not significantly different in patients whose distal resection margins were less than 2 cm, 2-2.9 cm, or greater than or equal to 3 cm. If any trend was observed, it appeared that patients with smaller resection margins had a slightly prolonged survival (p = 0.10). This observation was present in spite of the fact that local recurrence as a first site of treatment failure was greater in the group with less than 2 cm that it was in the greater than or equal to 3 cm category, 22% versus 12%. This increased local recurrence rate in the population with smaller margins was not translated into an in crease in overall treatment failure and had absolutely no influence on survival. It is suggested that local recurrence serves as a marker of distant disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3532972

  8. Current concepts in voiding dysfunction and dysfunctional voiding: A review from a urogynaecologist's perspective

    PubMed Central

    Karmakar, Debjyoti; Sharma, Jai B

    2014-01-01

    Background: Female voiding dysfunction is a complex disorder, lacks definition, and is poorly understood and difficult to manage. Causes of Female Voiding Dysfunction: As there is no agreed classification of female voiding dysfunction, it is important to identify the several potential factors that might cause voiding dysfunction, namely anatomic, neurogenic, pharmacologic, endocrine, pharmacological and other causes. Presentation and Clinical Evaluation: Traditional and novel techniques are available and the importance and diagnostic dilemma related to these conditions need to be understood. We conclude by emphasizing the need to simplify the diagnosis and nomenclature of these conditions from a more clinical point of view as against an investigational perspective. PMID:25316994

  9. Sinus node dysfunction complicating viper bite.

    PubMed

    Agarwal, Ashish; Kumar, Tarun; Ravindranath, Khandenahally S; Bhat, Prabhavathi; Manjunath, Cholenahally N; Agarwal, Neena

    2015-02-01

    Viper venom toxicities comprise mainly bleeding disorders and nephrotoxicity. Cardiotoxicity is a rare manifestation of viper bite. We describe the case of a previously healthy 35-year-old man who developed coagulopathy and sinus node dysfunction following a viper bite. Electrocardiography showed sinus arrest and junctional escape rhythm. This is the first account of sinus node dysfunction caused by a viper bite. PMID:24887872

  10. Sexual dysfunction in the medically ill

    Microsoft Academic Search

    Kristin J. Somers; Kemuel L. Philbrick

    2007-01-01

    Common in the medically ill, sexual dysfunction results from disruption of one or more stages of the sexual response cycle.\\u000a Increased understanding of sexual pathophysiology and the psychosocial forces whereby diseases impede normal function promotes\\u000a more informed treatment choices. This review focuses on the pathophysiology, impact, and treatment options of sexual dysfunction\\u000a in men and women with spinal cord injuries,

  11. Phosphodiesterase inhibitors in female sexual dysfunction

    Microsoft Academic Search

    Margit Mayer; Christian G. Stief; Michael C. Truss; Stefan Ückert

    2005-01-01

    Based on the increasing knowledge on both the physiology of penile erection and the pathophysiology of erectile dysfunction,\\u000a selective phosphodiesterase (PDE) inhibitors have been successfully introduced in the oral treatment of male erectile dysfunction.\\u000a Because of their central role in smooth muscle tone regulation, PDEs remain an attractive target for drug development in urology.\\u000a Since the distribution and functional significance

  12. Salivary gland dysfunction following radioactive iodine therapy

    SciTech Connect

    Wiesenfeld, D.; Webster, G.; Cameron, F.; Ferguson, M.M.; MacFadyen, E.E.; MacFarlane, T.W.

    1983-02-01

    Radioactive iodine is used extensively for the treatment of thyrotoxicosis and thyroid carcinoma. Iodine is actively taken up by the salivary glands and, following its use, salivary dysfunction may result as a consequence of radiation damage. The literature is reviewed and a case is reported in which a patient presented with a significant increase in caries rate attributed to salivary dysfunction following radioactive iodine therapy for a thyroid carcinoma.

  13. Ejaculatory dysfunction as a cause of infertility

    Microsoft Academic Search

    Nobuyuki Kondoh

    Ejaculatory dysfunction (EjD), the most prevalent male sexual disorder, is clearly different from erectile dysfunction (ED).\\u000a EjD is divided into 4 categories: premature ejaculation, delayed ejaculation, retrograde ejaculation and anejaculation. EjD-related\\u000a infertility is one of the most serious problems in young patients. If sexual intercourse is achieved successfully without\\u000a any ejaculate sexual partners\\/wives will not be able to conceive. Therefore,

  14. Vocal cord dysfunction mimicking bronchial asthma.

    PubMed

    Corren, J; Newman, K B

    1992-11-01

    Vocal cord dysfunction is a possible cause of wheezing and dyspnea in patients who do not respond to conventional asthma therapy. A carefully taken history, pulmonary function testing, and, most important, direct visualization with a flexible laryngoscope during an acute attack allow physicians to differentiate vocal cord dysfunction from asthma. Speech therapy, inhalation of helium and oxygen, and psychiatric counseling play a role in management. PMID:1437901

  15. Respiratory muscle dysfunction in facioscapulohumeral muscular dystrophy.

    PubMed

    Santos, Dante Brasil; Boussaid, Ghilas; Stojkovic, Tanya; Orlikowski, David; Letilly, Nadege; Behin, Anthony; Butel, Sandrine; Lofaso, Frédéric; Prigent, Hélène

    2015-08-01

    Respiratory insufficiency in facioscapulohumeral muscular dystrophy has rarely been studied. We compared two age- and sex-matched groups of 29 patients, with and without respiratory dysfunction. Tests in the 29 patients with respiratory dysfunction suggested predominant expiratory muscle dysfunction, leading to ineffective cough in 17 patients. Supine and upright vital capacities were not different (P?=?0.76), suggesting absence of diaphragmatic dysfunction. By stepwise regression, only expiratory reserve volume correlated with the Walton and Gardner-Medwin score (R(2)?=?0.503; P?=?0.001). Compared to controls, patients with respiratory dysfunction had higher values for the Walton and Gardner-Medwin score (6.1?±?1.9 vs. 3.2?±?1.2; P?<0.0001) and body mass index (26.9?±?6.0 vs. 22.9?±?4.0 kg/m(2); P?=?0.003) and a smaller number of D4Z4 allele repeats (4.8?±?1.6 vs. 5.7?±?1.8; P?=?0.05). Mechanical ventilation was required eventually in 20 patients, including 14 who were wheelchair bound. Three patients had acute respiratory failure requiring mechanical ventilation; 16 patients had poor airway clearance, including 10 with sleep apnea syndrome, responsible in 7 for chronic hypercapnia. Two patients presented isolated severe sleep apnea syndrome. Respiratory dysfunction in facioscapulohumeral muscular dystrophy is predominantly related to expiratory muscle weakness. Respiratory function and cough effectiveness should especially be monitored in patients with severe motor impairment and high body mass index. PMID:26023000

  16. Environmental enteric dysfunction: An overview

    PubMed Central

    Crane, Rosie J.; Jones, Kelsey D. J.; Berkley, James A.

    2015-01-01

    Background Environmental enteric dysfunction (EED) refers to an incompletely defined syndrome of inflammation, reduced absorptive capacity, and reduced barrier function in the small intestine. It is widespread among children and adults in low- and middle-income countries. Understanding of EED and its possible consequences for health is currently limited. Objective A narrative review of the current understanding of EED: epidemiology, pathogenesis, therapies, and relevance to child health. Methods Searches for key papers and ongoing trials were conducted using PUBMED 1966–June 2014; ClinicalTrials.gov; the WHO Clinical Trials Registry; the Cochrane Library; hand searches of the references of retrieved literature; discussions with experts; and personal experience from the field. Results EED is established during infancy and is associated with poor sanitation, certain gut infections, and micronutrient deficiencies. Helicobacter pylori infection, small intestinal bacterial overgrowth (SIBO), abnormal gut microbiota, undernutrition, and toxins may all play a role. EED is usually asymptomatic, but it is important due to its association with stunting. Diagnosis is frequently by the dual sugar absorption test, although other biomarkers are emerging. EED may partly explain the reduced efficacy of oral vaccines in low- and middle-income countries and the increased risk of serious infection seen in children with undernutrition. Conclusions Despite its potentially significant impacts, it is currently unclear exactly what causes EED and how it can be treated or prevented. Ongoing trials involve nutritional supplements, water and sanitation interventions, and immunomodulators. Further research is needed to better understand this condition, which is of likely crucial importance for child health and development in low- and middle-income settings. PMID:25902619

  17. Inflatable artificial sphincter

    MedlinePLUS

    ... perineal sling. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap ... in children. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap ...

  18. Apraxia and Motor Dysfunction in Corticobasal Syndrome

    PubMed Central

    Burrell, James R.; Hornberger, Michael; Vucic, Steve; Kiernan, Matthew C.; Hodges, John R.

    2014-01-01

    Background Corticobasal syndrome (CBS) is characterized by multifaceted motor system dysfunction and cognitive disturbance; distinctive clinical features include limb apraxia and visuospatial dysfunction. Transcranial magnetic stimulation (TMS) has been used to study motor system dysfunction in CBS, but the relationship of TMS parameters to clinical features has not been studied. The present study explored several hypotheses; firstly, that limb apraxia may be partly due to visuospatial impairment in CBS. Secondly, that motor system dysfunction can be demonstrated in CBS, using threshold-tracking TMS, and is linked to limb apraxia. Finally, that atrophy of the primary motor cortex, studied using voxel-based morphometry analysis (VBM), is associated with motor system dysfunction and limb apraxia in CBS. Methods Imitation of meaningful and meaningless hand gestures was graded to assess limb apraxia, while cognitive performance was assessed using the Addenbrooke's Cognitive Examination – Revised (ACE-R), with particular emphasis placed on the visuospatial subtask. Patients underwent TMS, to assess cortical function, and VBM. Results In total, 17 patients with CBS (7 male, 10 female; mean age 64.4+/? 6.6 years) were studied and compared to 17 matched control subjects. Of the CBS patients, 23.5% had a relatively inexcitable motor cortex, with evidence of cortical dysfunction in the remaining 76.5% patients. Reduced resting motor threshold, and visuospatial performance, correlated with limb apraxia. Patients with a resting motor threshold <50% performed significantly worse on the visuospatial sub-task of the ACE-R than other CBS patients. Cortical function correlated with atrophy of the primary and pre-motor cortices, and the thalamus, while apraxia correlated with atrophy of the pre-motor and parietal cortices. Conclusions Cortical dysfunction appears to underlie the core clinical features of CBS, and is associated with atrophy of the primary motor and pre-motor cortices, as well as the thalamus, while apraxia correlates with pre-motor and parietal atrophy. PMID:24664085

  19. Pelvic venoablation with ethanol for the treatment of erectile dysfunction due to veno-occlusive dysfunction

    Microsoft Academic Search

    Yoshiji Miwa; Rikiya Shioyama; Yasuhiko Itou; Hiroshi Kanamaru; Kenichiro Okada

    2001-01-01

    Objectives. To perform pelvic venoablation with ethanol injection into the deep dorsal vein for the treatment of 10 patients with venogenic erectile dysfunction. This procedure was easily performed without any selective embolization technique. The efficacy and safety of this technique are discussed.Methods. A total of 10 patients with veno-occlusive dysfunction, severe enough to make vaginal insertion impossible, underwent pelvic venoablation

  20. Sex therapy for female sexual dysfunction

    PubMed Central

    2013-01-01

    Introduction About 45% of women suffer from some form of sexual dysfunction. Despite its high prevalence, there are few studies that have systematically evaluated sex therapy in comparison with other interventions. Objective Review randomized clinical trials that present psychotherapeutic interventions for female sexual dysfunctions. Method Through a search in three databases (Medline, Web of Science and PsycInfo), 1419 references were found. After an analysis of the abstracts, twenty-seven articles met the inclusion criteria and composed this review. Results Sex therapy, as proposed by Masters and Johnson and Heiman and LoPiccolo, is still the most commonly used form of therapy for sexual dysfunctions; although it has shown results, the results do not consistently support that this is the best alternative in the treatment of sexual dysfunctions. Conclusion There is a lack of systematic study of many female sexual dysfunctions. Orgasmic disorder and sexual pain (vaginismus and dyspaurenia) are the most extensively studied disorders and those in which sex therapy seems to have better outcomes. PMID:24066697

  1. Vestibular Dysfunction in DFNB1 deafness

    PubMed Central

    Dodson, Kelley M; Blanton, Susan H; Welch, Katherine O; Norris, Virginia W; Nuzzo, Regina L; Wegelin, Jacob A.; Marin, Ruth S; Nance, Walter E; Pandya, Arti; Arnos, Kathleen S

    2010-01-01

    Mutations of GJB2 and GJB6 (connexin-26 and 30) at the DFNB1 locus are the most common cause of autosomal recessive, nonsyndromic deafness. Despite their widespread expression throughout the vestibular system, vestibular dysfunction has not been widely recognized as a commonly associated clinical feature. The observations of vertigo accompanying DFNB1 deafness in several large families prompted our hypothesis that vestibular dysfunction may be an integral, but often overlooked, component of DFNB1 deafness. Our aim was to define the prevalence of vestibular dysfunction in Cases of DFNB1 deafness and Controls with other forms of deafness. We developed and used a survey to assess symptoms of vestibular dysfunction, medical, and family history was distributed to Cases with deafness due to pathogenic GJB2 and/or GJB6 mutations and deaf Controls without DFNB1 deafness. Our results showed: Surveys were returned by 235/515 Cases (46%) with DFNB1 mutations and 121/ 321 Controls (38%) without these mutations. The mean age of Cases (41) was younger than Controls (51; p<0.001). Vestibular dysfunction was reported by 127 (54%) of Cases and was present at significantly higher rates in Cases than in deaf Controls without DFNB1 deafness (p< 0.03). Most (63%) had to lie down in order for vertigo to subside, and 48% reported that vertigo interfered with activities of daily living. Vertigo was reported by significantly more Cases with truncating than non-truncating mutations and was also associated with a family history of dizziness. We conclude that vestibular dysfunction appears to be more common in DFNB1 deafness than previously recognized and affects activities of daily living in many patients. PMID:21465647

  2. Endothelial Dysfunction in Children Without Hypertension

    PubMed Central

    Kim, Jinkwan; Alotaibi, Wadha H.; Kheirandish-Gozal, Leila; Capdevila, Oscar Sans; Gozal, David

    2012-01-01

    Background: Endothelial dysfunction can develop in the context of both obesity and obstructive sleep apnea (OSA) in children. However, the potential interactions between OSA and obesity have not been defined. Methods: Children who were prepubertal and nonhypertensive were recruited. Endothelial function was assessed in a morning fasted state, using a modified hyperemic test involving cuff-induced occlusion of the radial and ulnar arteries, and blood was drawn for assessment of myeloid-related protein 8/14 (MRP8/14) levels using a commercial enzyme-linked immunosorbent assay. Overnight polysomnography defined the presence of OSA or absence of OSA (NOSA) in subjects investigated for sleep-disordered breathing. Anthropometric measurements were performed to assign subjects to obese (OB) and nonobese (NOB) categories. Results: Fifty-four children with OSA who were obese and nonobese (mean age, 7.90 ± 0.26 years; mean BMI z-score, 1.70 ± 0.3; obstructive apnea-hypopnea index [OAHI], 7.36 ± 1.09) were compared with 54 children without OSA who were obese and nonobese (mean age, 8.26 ± 0.24 years; mean BMI z-score, 1.41 ± 0.18; OAHI, 0.86 ± 0.07). Of those subjects, 62.5% of the OB-OSA category, 38.7% of the OB-NOSA category, and 20.0% of the NOB-OSA category had evidence of endothelial dysfunction, compared with 0.0% of the NOB-NOSA category (P < .01). The degree of endothelial dysfunction in all groups was associated with circulating MRP8/14 levels (r = 0.343, P < .001). Conclusions: Both obesity and OSA can independently increase the risk for endothelial dysfunction, and the concurrent presence of both markedly increases such risk. Although the mechanisms underlying endothelial dysfunction remain unclear, a potential role for MRP8/14 as an inflammatory biomarker of endothelial dysfunction is suggested. PMID:22030801

  3. Temporomandibular Joint Dysfunction: A Dental Overview

    PubMed Central

    Hillier, Clyde D.

    1985-01-01

    Temporomandibular joint dysfunction is common and often acutely painful. Because of the large and diverse symptom complex created by this disorder, patients frequently first seek relief from their physician rather than their dentist. In this article temporomandibular joint (TMJ) dysfunction is defined and the presenting signs and symptoms are discussed. Their etiology is described in relation to the anatomy of the temporomandibular joint. Examination techniques can help in the differential diagnosis. Current treatment ranges from heat, local anesthesia and ultrasound to anxiolytics, transcutaneous nerve stimulation and nutritional supplementation. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8 PMID:21274225

  4. Pharmacological approaches to coronary microvascular dysfunction.

    PubMed

    Guarini, Giacinta; Huqi, Alda; Morrone, Doralisa; Capozza, Paola; Todiere, Giancarlo; Marzilli, Mario

    2014-12-01

    In recent decades coronary microvascular dysfunction has been increasingly identified as a relevant contributor to several cardiovascular conditions. Indeed, coronary microvascular abnormalities have been recognized in patients suffering acute myocardial infarction, chronic stable angina and cardiomyopathies, and also in patients with hypertension, obesity and diabetes. In this review, we will examine pathophysiological information needed to understand pharmacological approaches to coronary microvascular dysfunction in these different clinical contexts. Well-established drugs and new pharmacological agents, including those for which only preclinical data are available, will be covered in detail. PMID:25004087

  5. Transplantation of muscle-derived stem cells plus biodegradable fibrin glue restores the urethral sphincter in a pudendal nerve-transected rat model.

    PubMed

    Xu, Y; Song, Y F; Lin, Z X

    2010-11-01

    We investigated whether fibrin glue (FG) could promote urethral sphincter restoration in muscle-derived stem cell (MDSC)-based injection therapies in a pudendal nerve-transected (PNT) rat, which was used as a stress urinary incontinence (SUI) model. MDSCs were purified from the gastrocnemius muscles of 4-week-old inbred female SPF Wistar rats and labeled with green fluorescent protein. Animals were divided into five groups (N = 15): sham (S), PNT (D), PNT+FG injection (F), PNT+MDSC injection (M), and PNT+MDSC+FG injection (FM). Each group was subdivided into 1- and 4-week groups. One and 4 weeks after injection into the proximal urethra, leak point pressure (LPP) was measured to assess urethral resistance function. Histology and immunohistochemistry were performed 4 weeks after injection. LPP was increased significantly in FM and M animals after implantation compared to group D (P < 0.01), but was not different from group S. LPP was slightly higher in the FM group than in the M group but there was no significant difference between them at different times. Histological and immunohistochemical examination demonstrated increased numbers of surviving MDSCs (109 ± 19 vs 82 ± 11/hpf, P = 0.026), increased muscle/collagen ratio (0.40 ± 0.02 vs 0.34 ± 0.02, P = 0.044), as well as increased microvessel density (16.9 ± 0.6 vs 14.1 ± 0.4/hpf, P = 0.001) at the injection sites in FM compared to M animals. Fibrin glue may potentially improve the action of transplanted MDSCs to restore the histology and function of the urethral sphincter in a SUI rat model. Injection of MDSCs with fibrin glue may provide a novel cellular therapy method for SUI. PMID:21088804

  6. Feeding and Swallowing Dysfunction in Genetic Syndromes

    ERIC Educational Resources Information Center

    Cooper-Brown, Linda; Copeland, Sara; Dailey, Scott; Downey, Debora; Petersen, Mario Cesar; Stimson, Cheryl; Van Dyke, Don C.

    2008-01-01

    Children with genetic syndromes frequently have feeding problems and swallowing dysfunction as a result of the complex interactions between anatomical, medical, physiological, and behavioral factors. Feeding problems associated with genetic disorders may also cause feeding to be unpleasant, negative, or even painful because of choking, coughing,…

  7. Management of sexual dysfunction in Parkinson's disease.

    PubMed

    Bronner, Gila; Vodušek, David B

    2011-11-01

    Nonmotor symptoms, among them sexual dysfunction, are common and underrecognized in patients with Parkinson disease; they play a major role in the deterioration of quality of life of patients and their partners. Loss of desire and dissatisfaction with their sexual life is encountered in both genders. Hypersexuality (HS), erectile dysfunction and problems with ejaculation are found in male patients, and loss of lubrication and involuntary urination during sex are found in female patients. Tremor, hypomimia, muscle rigidity, bradykinesia, 'clumsiness' in fine motor control, dyskinesias, hypersalivation and sweating may interfere with sexual function. Optimal dopaminergic treatment should facilitate sexual encounters of the couple. Appropriate counselling diminishes some of the problems (reluctance to engage in sex, problems with ejaculation, lubrication and urinary incontinence). Treatment of erectile dysfunction with sildenafil and apomorphine is evidence based. HS or compulsive sexual behaviour are side effects of dopaminergic therapy, particularly by dopaminergic agonists, and should be treated primarily by diminishing their dose. Neurologists should actively investigate sexual dysfunction in their Parkinsonian patients and offer treatment, optimally within a multidisciplinary team, where a dedicated professional would deal with sexual counselling. PMID:22164191

  8. Hepatitis C Virus-Induced Mitochondrial Dysfunctions

    PubMed Central

    Brault, Charlène; Levy, Pierre L.; Bartosch, Birke

    2013-01-01

    Chronic hepatitis C is characterized by metabolic disorders and a microenvironment in the liver dominated by oxidative stress, inflammation and regeneration processes that lead in the long term to hepatocellular carcinoma. Many lines of evidence suggest that mitochondrial dysfunctions, including modification of metabolic fluxes, generation and elimination of oxidative stress, Ca2+ signaling and apoptosis, play a central role in these processes. However, how these dysfunctions are induced by the virus and whether they play a role in disease progression and neoplastic transformation remains to be determined. Most in vitro studies performed so far have shown that several of the hepatitis C virus (HCV) proteins localize to mitochondria, but the consequences of these interactions on mitochondrial functions remain contradictory, probably due to the use of artificial expression and replication systems. In vivo studies are hampered by the fact that innate and adaptive immune responses will overlay mitochondrial dysfunctions induced directly in the hepatocyte by HCV. Thus, the molecular aspects underlying HCV-induced mitochondrial dysfunctions and their roles in viral replication and the associated pathology need yet to be confirmed in the context of productively replicating virus and physiologically relevant in vitro and in vivo model systems. PMID:23518579

  9. Hysterectomy as treatment for dysfunctional uterine bleeding

    Microsoft Academic Search

    Harry Reich; Sergio Conti Ribeiro; Andrea Vidali

    1999-01-01

    The surgical treatment of patients with dysfunctional uterine bleeding (DUB) is discussed in this chapter, including indications, techniques and complications. Hysterectomy is the definitive treatment for DUB; in most studies it has a higher rate of patient satisfaction than does hysteroscopic endometrial ablation. The vaginal or laparoscopic approach should be selected in this group of patients with small uteri, while

  10. NUTRIENT MEDIATED PROTECTION AGAINST ENDOTHELIAL CELL DYSFUNCTION

    Microsoft Academic Search

    Gudrun Reiterer

    2004-01-01

    Atherosclerosis is thought to be initiated by endothelial cell dysfunction. Research described in this dissertation is focused on interactions of nutrients, cytokines and pharmaceutical compounds in the intracellular signaling pathways leading to endothelial cell activation. The flavonoid quercetin could significantly downregulate the inflammatory pathways induced by linoleic acid as determined by DNA binding assays of the proinflammatory transcription factors nuclear

  11. Cardiovascular dysfunction in patients with liver cirrhosis

    PubMed Central

    Fede, Giuseppe; Privitera, Graziella; Tomaselli, Tania; Spadaro, Luisa; Purrello, Francesco

    2015-01-01

    Hyperdynamic syndrome is a well-known clinical condition found in patients with cirrhosis and portal hypertension, characterized by increased heart rate and cardiac output, and reduced systemic vascular resistance and arterial blood pressure. The leading cause of hyperdynamic circulation in cirrhotic patients is peripheral and splanchnic vasodilatation, due to an increased production/activity of vasodilator factors and decreased vascular reactivity to vasoconstrictors. The term “cirrhotic cardiomyopathy” describes impaired contractile responsiveness to stress, diastolic dysfunction and electrophysiological abnormalities in patients with cirrhosis without known cardiac disease. Underlying circulatory and cardiac dysfunctions are the main determinant in the development of hepatorenal syndrome in advanced cirrhosis. Moreover, the clinical consequences of cirrhosis-related cardiovascular dysfunction are evident during and after liver transplantation, and after transjugular intrahepatic portosystemic shunt insertion. Cardiovascular complications following these procedures are common, with pulmonary edema being the most common complication. Other complications include overt heart failure, arrhythmia, pulmonary hypertension, pericardial effusion, and cardiac thrombus formation. This review discusses the circulatory and cardiovascular dysfunctions in cirrhosis, examining the pathophysiologic and clinical implications in light of the most recent published literature. PMID:25608575

  12. Podocyte dysfunction in atypical haemolytic uraemic syndrome.

    PubMed

    Noris, Marina; Mele, Caterina; Remuzzi, Giuseppe

    2015-04-01

    Genetic or autoimmune defects that lead to dysregulation of the alternative pathway of complement have been associated with the development of atypical haemolytic uraemic syndrome (aHUS), which is characterized by thrombocytopenia, haemolytic anaemia and acute kidney injury. The relationship between aHUS, podocyte dysfunction and the resultant proteinuria has not been adequately investigated. However, the report of mutations in diacylglycerol kinase ? (DGKE) as a cause of recessive infantile aHUS characterized by proteinuria, highlighted podocyte dysfunction as a potential complication of aHUS. DGKE deficiency was originally thought to trigger aHUS through pathogenetic mechanisms distinct from complement dysregulation; however, emerging findings suggest an interplay between DGKE and complement systems. Podocyte dysfunction with nephrotic-range proteinuria can also occur in forms of aHUS associated with genetic or autoimmune complement dysregulation without evidence of DGKE mutations. Furthermore, proteinuric glomerulonephritides can be complicated by aHUS, possibly as a consequence of podocyte dysfunction inducing endothelial injury and prothrombotic abnormalities. PMID:25599621

  13. EAU Guidelines on Erectile Dysfunction: An Update

    Microsoft Academic Search

    Eric Wespes; Edouard Amar; Dimitrios Hatzichristou; Kosta Hatzimouratidis; Francesco Montorsi; John Pryor; Yoram Vardi

    2006-01-01

    The introduction of new oral therapies has completely changed the diagnostic and therapeutic approach to erectile dysfunction. A panel of experts in this field has developed guidelines for the clinical evaluation and treatment based on the review of available scientific information.

  14. Public Education for Children with Brain Dysfunction.

    ERIC Educational Resources Information Center

    Rappaport, Sheldon R.

    A foreword by William M. Cruickshank introduces a book designed to provide information on the problems of children with brain dysfunction and to furnish guidelines to habilitation. Subjects discussed are the status of education for these children, preparing the community for a school program, selection of school and preparation of the principal,…

  15. Renal tubular dysfunction in ?-thalassemia minor

    Microsoft Academic Search

    Turker Cetin; Cagatay Oktenli; Taner Ozgurtas; Mujdat Yenicesu; S. Yavuz Sanisoglu; Yusuf Oguz; Oguzhan Yildiz; Ismail Kurt; Ugur Musabak; Fatih Bulucu; Ismail H Kocar

    2003-01-01

    Background: Persons with ?-thalassemia minor usually are symptomless. However, we previously reported renal tubular dysfunction in a patient with ?-thalassemia minor. The aim of this study is to investigate renal function in patients with ?-thalassemia minor. Methods: Forty-one subjects with ?-thalassemia minor and 20 sex- and age-matched healthy subjects were enrolled in the study. For analysis, patients were divided into

  16. Treatment of erectile dysfunction with sildenafil

    Microsoft Academic Search

    Leonard S Marks; Catherine Duda; Frederick J Dorey; Maria Luz Macairan; Paul Bryan Santos

    1999-01-01

    Objectives. To determine the efficacy of sildenafil for the treatment of erectile dysfunction (ED) in a clinical practice setting; to evaluate the correlation between patient and partner perceptions of treatment outcomes; and to assess the relation between the severity of ED and response to treatment.Methods. Among the first 100 men to receive sildenafil in a urology practice setting, 74 (mean

  17. Cerebral dysfunction after coronary artery bypass surgery.

    PubMed

    Goto, Tomoko; Maekawa, Kengo

    2014-04-01

    Cerebral dysfunction after cardiac surgery remains a devastating complication and is growing in importance with our aging populations. Neurological complications following cardiac surgery can be classified broadly as stroke, encephalopathy (including delirium), or postoperative cognitive dysfunction (POCD). These etiologies are caused primary by cerebral emboli, hypoperfusion, or inflammation that has largely been attributed to the use of cardiopulmonary bypass. Preventative operative strategies, such as off-pump coronary artery bypass grafting (CABG), can potentially reduce the incidence of postoperative neurological complications by avoiding manipulation of the ascending aorta. Although off-pump CABG is associated with reduced risk of stroke, there are no convincing differences in POCD between off-pump and on-pump CABG. Recently, the focus of postoperative neurological research has shifted from managing cardiopulmonary bypass to patient-related factors. Identifying changes in brains of aged individuals undergoing cardiac surgery may improve strategies for preventing cerebral dysfunction. Advanced age is associated with more undiagnosed cerebrovascular disease and is a major risk factor for stroke and POCD following cardiac surgery. Preoperative cerebrovascular evaluation and adaptation of surgical strategies will provide preventative approaches for cerebral dysfunction after CABG. This review focuses on recent findings of the relationship between perioperative stress and underlying fragility of the brain in cardiac surgical patients. PMID:23982856

  18. Endothelial Dysfunction in Chronic Inflammatory Diseases

    PubMed Central

    Steyers, Curtis M.; Miller, Francis J.

    2014-01-01

    Chronic inflammatory diseases are associated with accelerated atherosclerosis and increased risk of cardiovascular diseases (CVD). As the pathogenesis of atherosclerosis is increasingly recognized as an inflammatory process, similarities between atherosclerosis and systemic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel diseases, lupus, psoriasis, spondyloarthritis and others have become a topic of interest. Endothelial dysfunction represents a key step in the initiation and maintenance of atherosclerosis and may serve as a marker for future risk of cardiovascular events. Patients with chronic inflammatory diseases manifest endothelial dysfunction, often early in the course of the disease. Therefore, mechanisms linking systemic inflammatory diseases and atherosclerosis may be best understood at the level of the endothelium. Multiple factors, including circulating inflammatory cytokines, TNF-? (tumor necrosis factor-?), reactive oxygen species, oxidized LDL (low density lipoprotein), autoantibodies and traditional risk factors directly and indirectly activate endothelial cells, leading to impaired vascular relaxation, increased leukocyte adhesion, increased endothelial permeability and generation of a pro-thrombotic state. Pharmacologic agents directed against TNF-?-mediated inflammation may decrease the risk of endothelial dysfunction and cardiovascular disease in these patients. Understanding the precise mechanisms driving endothelial dysfunction in patients with systemic inflammatory diseases may help elucidate the pathogenesis of atherosclerosis in the general population. PMID:24968272

  19. Mitochondrial dysfunction increases allergic airway inflammation1

    PubMed Central

    Aguilera-Aguirre, Leopoldo; Bacsi, Attila; Saavedra-Molina, Alfredo; Kurosky, Alexander; Sur, Sanjiv; Boldogh, Istvan

    2011-01-01

    Pollen grains and subpollen particles contain NAD(P)H oxidases and shown to induce oxidative stress in the airway epithelium; however, the role of mitochondrial dysfunction induced by them has not been investigated on airway inflammation. Our results show that exposure of airway epithelial cells to ragweed pollen extract (RWE) induced oxidative modifications to NADH dehydrogenase (ubiquinone) Fe-S protein (NDUFS) 1 and NDUFS2 in mitochondrial respiratory complex I, as well as ubiquinol-cytochrome c reductase core protein I (UQCRC1) and II (UQCRC2) in complex III. Respiratory chain-associated proteins, the 75-kDa glucose-regulated protein, heat shock protein 70, heat shock protein 60, citrate synthase and voltage-dependent anion selective channel 1 were also damaged. Exposure of cells to RWE induced mitochondrial dysfunction as shown by increased H2O2 release from respiratory chain complex III. Mitochondrial dysfunction induced by antisense oligonucleotides to UQCRC2 increased mitochondrial ROS generation in lung epithelial cells. Most importantly, mitochondrial dysfunction in airway epithelium of sensitized Balb/c mice prior the RWE challenge increases the RWE-induced accumulation of eosinophils, mucin levels in the airways and bronchial hyperresponsiveness. A decrease in UQCRC1 expression did not significantly alter cellular ROS levels and parameters of airway inflammation. Based on these observations preexisting mitochondrial dysfunction induced by oxidant environmental pollutants and/or pollen grains exacerbate antigen-driven allergic airway inflammation. These data also imply that mitochondrial defect could be a risk factor and may be responsible for severe allergic disorders in atopic individuals. PMID:19786549

  20. Vascular dysfunctions following spinal cord injury

    PubMed Central

    Popa, F; Grigorean, VT; Onose, G; Sandu, AM; Popescu, M; Burnei, G; Strambu, V; Sinescu, C

    2010-01-01

    The aim of this article is to analyze the vascular dysfunctions occurring after spinal cord injury (SCI). Vascular dysfunctions are common complications of SCI. Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of SCI. Neuroanatomy and physiology of autonomic nervous system, sympathetic and parasympathetic, is reviewed. SCI implies disruption of descendent pathways from central centers to spinal sympathetic neurons, originating in intermediolateral nuclei of T1–L2 cord segments. Loss of supraspinal control over sympathetic nervous system results in reduced overall sympathetic activity below the level of injury and unopposed parasympathetic outflow through intact vagal nerve. SCI associates significant vascular dysfunction. Spinal shock occurs during the acute phase following SCI and it is a transitory suspension of function and reflexes below the level of the injury. Neurogenic shock, part of spinal shock, consists of severe arterial hypotension and bradycardia. Autonomic dysreflexia appears during the chronic phase, after spinal shock resolution, and it is a life–threatening syndrome of massive imbalanced reflex sympathetic discharge occurring in patients with SCI above the splanchnic sympathetic outflow (T5–T6). Arterial hypotension with orthostatic hypotension occurs in both acute and chronic phases. The etiology is multifactorial. We described a few factors influencing the orthostatic hypotension occurrence in SCI: sympathetic nervous system dysfunction, low plasma catecholamine levels, rennin–angiotensin–aldosterone activity, peripheral alpha–adrenoceptor hyperresponsiveness, impaired function of baroreceptors, hyponatremia and low plasmatic volume, cardiovascular deconditioning, morphologic changes in sympathetic neurons, plasticity within spinal circuits, and motor deficit leading to loss of skeletal muscle pumping activity. Additional associated cardiovascular concerns in SCI, such as deep vein thrombosis and long–term risk for coronary heart disease and systemic atherosclerosis are also described. Proper prophylaxis, including non–pharmacologic and pharmacological strategies, diminishes the occurrence of the vascular dysfunction following SCI. Each vascular disturbance requires a specific treatment. PMID:20945818

  1. Defining association between sleep apnea syndrome and erectile dysfunction

    Microsoft Academic Search

    Patrick E. Teloken; Eric B. Smith; Chris Lodowsky; Thomas Freedom; John P. Mulhall

    2006-01-01

    ObjectivesTo conduct a study using validated sexual function and sleepiness inventories to define whether sleep apnea syndrome (SAS) is associated with erectile dysfunction and whether any correlation exists between the severity of SAS and the severity of erectile dysfunction. Previous work has suggested that sleep disorders are associated with erectile dysfunction.

  2. Psychological Impact of Erectile Dysfunction: Validation of a New Health Related Quality of Life Measure for Patients With Erectile Dysfunction

    Microsoft Academic Search

    DAVID M. LATINI; DAVID F. PENSON; HILARY H. COLWELL; DEBORAH P. LUBECK; SHILPA S. MEHTA; JAMES M. HENNING; TOM F. LUE

    2002-01-01

    PurposeMale erectile dysfunction has a substantial impact on health related quality of life. We examined the psychometric properties of 2 new scales created to measure the psychological impact of erectile dysfunction.

  3. [Management of erectile dysfunction after radical prostatectomy].

    PubMed

    Droupy, S

    2009-12-01

    The objective of a radical prostectomy is to cure cancer of the prostate while preserving the best quality of life of patients. Changes in the quality of erections after the operation pose the greatest problems as far as sexuality is concerned. This is the consequence of lesions of the cavernous nerves during the lateral dissection of the prostate, which are sometimes definitive. The treatment of erectile dysfunction after radical prostectomy begins with an evaluation of the sexuality of the patient who is informed of the consequences of surgery before operating. Specialized physiotherapy should be proposed to patients in the 2 to 3 months following the intervention. Should this treatment prove to be unsuccessful, patients are treated using classical therapy for erectile dysfunction. In the case of patient transfer and delegation of competences, consultation between the doctor and clinical nurses is advised throughout treatment. PMID:19963187

  4. Tadalafil therapy for erectile dysfunction following prostatectomy

    PubMed Central

    Kad?o?lu, Ate?; Ortaç, Mazhar; Dinçer, Murat

    2015-01-01

    Erectile dysfunction is a major complication affecting the quality of life of patients and partners after radical prostatectomy. Evolving evidence suggests that early penile rehabilitation may provide better erectile function after surgery. Phosphodiesterase type 5 (PDE-5) inhibitors are routinely considered a first-line treatment option in most algorithms for penile rehabilitation owing to their efficacy, ease of use, wide availability and minimal morbidity. Tadalafil is a long-acting, potent PDE-5 inhibitor for erectile dysfunction, with demonstrated effect in animal studies at preserving penile smooth muscle content and prevention of fibrosis of cavernosal tissue. This article evaluates the existing literature on tadalafil and critically analyzes its impact on erectile function following radical prostatectomy. PMID:26161145

  5. Tadalafil therapy for erectile dysfunction following prostatectomy.

    PubMed

    Kad?o?lu, Ate?; Ortaç, Mazhar; Dinçer, Murat; Brock, Gerald

    2015-06-01

    Erectile dysfunction is a major complication affecting the quality of life of patients and partners after radical prostatectomy. Evolving evidence suggests that early penile rehabilitation may provide better erectile function after surgery. Phosphodiesterase type 5 (PDE-5) inhibitors are routinely considered a first-line treatment option in most algorithms for penile rehabilitation owing to their efficacy, ease of use, wide availability and minimal morbidity. Tadalafil is a long-acting, potent PDE-5 inhibitor for erectile dysfunction, with demonstrated effect in animal studies at preserving penile smooth muscle content and prevention of fibrosis of cavernosal tissue. This article evaluates the existing literature on tadalafil and critically analyzes its impact on erectile function following radical prostatectomy. PMID:26161145

  6. Computational tools in rehabilitation of erectile dysfunction.

    PubMed

    Gefen, A; Chen, J; Elad, D

    2001-03-01

    Erectile dysfunction (ED) is defined as the inability to achieve and maintain an erection adequate for satisfactory intercourse. It is a common problem among approximately 50% of men between the ages of 40 and 70. Erectile dysfunction is not only stressful to both the affected individual and his partner, but it can also negatively affect self-esteem. Biomechanical models have recently been developed to study both the structural and hemodynamic factors involved in normal and pathological erectile conditions. These computational models, which are reviewed in the present paper, allow for better understanding of the mechanisms acting in ED and provide a suitable basis for development of state-of-the-art interdisciplinary treatment approaches aimed to improve the quality of life for these men. PMID:11413059

  7. Mitochondrial dysfunction and insulin resistance: an update

    PubMed Central

    Montgomery, Magdalene K; Turner, Nigel

    2014-01-01

    Mitochondrial dysfunction has been implicated in the development of insulin resistance (IR); however, a large variety of association and intervention studies as well as genetic manipulations in rodents have reported contrasting results. Indeed, even 39 years after the first publication describing a relationship between IR and diminished mitochondrial function, it is still unclear whether a direct relationship exists, and more importantly if changes in mitochondrial capacity are a cause or consequence of IR. This review will take a journey through the past and summarise the debate about the occurrence of mitochondrial dysfunction and its possible role in causing decreased insulin action in obesity and type 2 diabetes. Evidence is presented from studies in various human populations, as well as rodents with genetic manipulations of pathways known to affect mitochondrial function and insulin action. Finally, we have discussed whether mitochondria are a potential target for the treatment of IR. PMID:25385852

  8. Right Ventricular Dysfunction in Chronic Lung Disease

    PubMed Central

    Kolb, Todd M.; Hassoun, Paul M.

    2012-01-01

    Right ventricular dysfunction arises in chronic lung disease when chronic hypoxemia and disruption of pulmonary vascular beds contribute to increase ventricular afterload, and is generally defined by hypertrophy with preserved myocardial contractility and cardiac output. Although the exact prevalence is unknown, right ventricular hypertrophy appears to be a common complication of chronic lung disease, and more frequently complicates advanced lung disease. Right ventricular failure is rare, except during acute exacerbations of chronic lung disease or when multiple co-morbidities are present. Treatment is targeted at correcting hypoxia and improving pulmonary gas exchange and mechanics. There are presently no convincing data to support the use of pulmonary hypertension-specific therapies in patients with right ventricular dysfunction secondary to chronic lung disease. PMID:22548815

  9. Revascularization in severe left ventricular dysfunction.

    PubMed

    Velazquez, Eric J; Bonow, Robert O

    2015-02-17

    The highest-risk patients with heart failure with reduced ejection fraction are those with ischemic cardiomyopathy and severe left ventricular systolic dysfunction (ejection fraction?35%). The cornerstone of treatment is guideline-driven medical therapy for all patients and implantable device therapy for appropriately selected patients. Surgical revascularization offers the potential for improved survival and quality of life, particularly in patients with more extensive multivessel disease and the greatest degree of left ventricular systolic dysfunction and remodeling. These are also the patients at greatest short-term risk of mortality with coronary artery bypass graft surgery. The short-term risks of surgery need to be balanced against the potential for long-term benefit. This review discusses the evolving data on the role of surgical revascularization, surgical ventricular reconstruction, and mitral valve surgery in this high-risk patient population. PMID:25677320

  10. Alprostadil for the treatment of erectile dysfunction.

    PubMed

    Costabile, R A

    1999-06-01

    Erectile dysfunction (ED) is a common medical condition affecting over 20 m men in the United States. Efficacious medical therapy for the treatment of erectile dysfunction has been available since the early 1980s and can be divided into local pharmacotherapy and systemic therapy. Alprostadil, a synthetic form of prostaglandin E1, is a useful local pharmacotherapeutic agent for the treatment ED. Alprostadil is presently available for administration as an intracavernosal injection or an intraurethral suppository. Local alprostadil therapy is effective at restoring the ability to participate in intercourse in up to 70% of men with ED. The principle side-effects of alprostadil are local, with few systemic reactions. The mechanism of alprostadil, its efficacy in clinical trials and side-effects are examined to outline the utility of alprostadil for the treatment of ED. PMID:15992137

  11. Sexual dysfunctions of chronic schizophrenic female patients

    Microsoft Academic Search

    I. V. Miclutia; C. A. Popescu; R. S. Macrea

    2008-01-01

    Schizophrenic patients reveal sexual dysfunctions at the onset of the disorder but more profound in chronicity, after long-term anti-psychotic treatment. Various aspects of the sexuality of chronic female schizophrenic patients and sexual side-effects of conventional and atypical anti-psychotics were evaluated. Fifty female chronic schizophrenic patients treated with conventional and atypical anti-psychotics, compared to 50 matched controls, were assessed with: PANSS,

  12. Insight, cognitive dysfunction and symptomatology in schizophrenia

    Microsoft Academic Search

    Luciana C. Monteiro; Vanessa A. Silva; Mario R. Louzã

    2008-01-01

    Lack of insight is frequent in schizophrenia and usually influences negatively both patient’s treatment and prognosis. This\\u000a study aimed to investigate the relationship between insight, symptomatology and cognitive dysfunctions in schizophrenia using\\u000a the PANSS five-factor model (modified from Gaag et al. in Schizophr Res 85:280–287, 2006). Forty patients diagnosed with chronic\\u000a schizophrenia (DSM-IV) were evaluated with the scale to assess

  13. Minor Neurological Dysfunction in Children with Dyslexia

    ERIC Educational Resources Information Center

    Punt, Marja; de Jong, Marianne; de Groot, Erik; Hadders-Algra, Mijna

    2010-01-01

    Aim: To improve understanding of brain function in children with severe dyslexia in terms of minor neurological dysfunctions (MNDs). Method: One hundred and four children (81 males, 23 females; age range 7-12y; mean age 9y 7mo, SD 1y 2mo;) with severe dyslexia (the presence of a Full-scale IQ score of greater than or equal to 85, retardation in…

  14. Female neurogenic vesicourethral dysfunction: Evaluation and management

    Microsoft Academic Search

    Rebecca J. McCrery; Rodney A. Appell

    2006-01-01

    This paper outlines the evaluation and management of neurogenic vesicourethral dysfunction (NVUD). The anatomy and neurophysiology\\u000a involved with lower urinary tract functions are reviwed. Multiple sclerosis, diabetes, lumbar disc prolapse, and Parkinson’s\\u000a disease are specifically addressed. Proper evaluation of patients suspected of having NVUD, which is fundamental to making\\u000a an accurate diagnosis, is discussed. This is followed by options for

  15. Female neurogenic vesicourethral dysfunction: evaluation and management

    Microsoft Academic Search

    Rebecca J. McCrery; Rodney A. Appell

    2005-01-01

    This paper outlines the evaluation and management of neurogenic vesicourethral dysfunction (NVUD). The anatomy and neurophysiology\\u000a involved with lower urinary tract functions are reviewed. Multiple sclerosis, diabetes, lumbar disc prolapse, and Parkinson’s\\u000a disease are specifically addressed. Proper evaluation of patients suspected of having NVUD, which is fundamental to making\\u000a an accurate diagnosis, is discussed. This is followed by options for

  16. Endothelial dysfunction during acute alcohol withdrawal syndrome

    Microsoft Academic Search

    Thomas Jochum; Markus Weissenfels; Andrea Seeck; Steffen Schulz; Michael K. Boettger; Andreas Voss; Karl-Jürgen Bär

    2011-01-01

    BackgroundEndothelial dysfunction (EF) is a central phenomenon in a variety of conditions associated with increased cardiovascular morbidity. Here, we investigated EF during acute alcohol withdrawal syndrome before and 24h after medication. We aimed to analyze microcirculation, applying the post-occlusive reactive hyperemia (PORH) test and spectral analysis of skin vasomotion as markers of EF. Additionally, we explored whether segmentation of spectral

  17. Management of erectile dysfunction following radical prostatectomy

    Microsoft Academic Search

    Craig D. Zippe; Rupesh Raina; Mamta Thukral; Milton M. Lakin; Eric A. Klein; Ashok Agarwal

    2001-01-01

    Radical prostatectomy is the standard treatment for organ\\/ specimen-confined prostate cancer, yet erectile dysfunction in\\u000a selected series is still reported as high as 90% after this procedure. Thus, most men need adjuvant treatments to be sexually\\u000a active following radical prostatectomy. These include vacuum constriction devices, intracorporeal injections of vasoactive\\u000a drugs, and transurethral dilators, all of which have reported response rates

  18. Post-LASIK Tear Dysfunction and Dysesthesia

    PubMed Central

    NETTUNE, GREGORY R.; PFLUGFELDER, STEPHEN C.

    2013-01-01

    Symptoms of tear dysfunction after laser in situ keratomileusis (LASIK) occur in nearly all patients and resolve in the vast majority. Although dry eye complaints are a leading cause of patient discomfort and dissatisfaction after LASIK, the symptoms are not uniform, and the disease is not a single entity. Post-LASIK tear dysfunction syndrome or dry eye is a term used to describe a spectrum of disease encompassing transient or persistent post-operative neurotrophic disease, tear instability, true aqueous tear deficiency, and neuropathic pain states. Neural changes in the cornea and neuropathic causes of ocular surface discomfort may play a separate or synergistic role in the development of symptoms in some patients. Most cases of early post-operative dry eye symptoms resolve with appropriate management, which includes optimizing ocular surface health before and after surgery. Severe symptoms or symptoms persisting after 9 months rarely respond satisfactorily to traditional treatment modalities and require aggressive management. This review covers current theories of post-LASIK dry eye disease, pathophysiology, risk factors, and management options for this disease spectrum of post-LASIK tear dysfunction and neuropathic pain. PMID:20712970

  19. Episodic neurological dysfunction in hereditary peripheral neuropathy

    PubMed Central

    Kulkarni, Girish Baburao; Mailankody, Pooja; Isnwara, Pawanraj Palu; Prasad, Chandrajit; Mustare, Veerendrakumar

    2015-01-01

    Episodic transient neurological symptoms are an important set of problems presenting to a neurologist in his routine practice. Occasionally, detailed clinical history including past and family history supplemented with focused examination can bring out a rare cause for such symptoms. We describe in this report in a young male presenting with episodic focal neurological dysfunction, with family history of similar episodes in mother and brother. Examination showed features of pes cavus and peripheral neuropathy for which patient was asymptomatic. Mother and brother were established cases of hereditary neuropathy. Imaging on multiple occasions showed reversible white matter abnormalities. Clinical suspicion of X-linked Charcot-Marie-Tooth disease type 1 (CMT1X) was confirmed with detection of mutation in Gap Junction B1 (GJB1) gene, which codes for connexin 32 protein (c.425G>A; p.R142Q hemizygous mutation). Though this mutation has been already reported in CMTX patients, it has not been associated with transient neurological dysfunctions. This is probably the first reported case of CMTX patient with transient neurological dysfunction from India, whose family members had similar episodes. PMID:25745327

  20. Ammonia drives dendritic cells into dysfunction.

    PubMed

    Luo, Can; Shen, Guobo; Liu, Ning; Gong, Fengming; Wei, Xiawei; Yao, Shaohua; Liu, Dan; Teng, Xiu; Ye, Ning; Zhang, Nan; Zhou, Xikun; Li, Jiong; Yang, Li; Zhao, Xia; Yang, Li; Xiang, Rong; Wei, Yu-Quan

    2014-08-01

    Ammonia levels are often elevated in patients with cirrhosis or tumors. Patients with these diseases are immunocompromised. In this study, we investigated the effects of ammonia on a member of the immune cell family, the dendritic cells (DCs). Our results demonstrated that ammonia diminished cell count, phagocytosis, and lymphocyte stimulation of DCs. Ammonia also induced DC swelling, excessive reactive oxygen species production, and mitochondrial damage, which may constitute the underlying mechanism of ammonia-induced DC dysfunction. In ammonium chloride (NH4Cl)-loaded mice, DCs exhibited lowered phagocytosis and a weakened immune response to the chicken OVA vaccine. DCs from patients with cirrhosis or ammonia-treated healthy human blood both exhibited diminished phagocytosis. Moreover, tumor cell conditioned medium drove DCs into dysfunction, which could be reversed by ammonia elimination. In a murine colon carcinoma model, we found that ammonia could regulate tumor growth involving DCs and their related immune response. These findings reveal that ammonia could drive DCs into dysfunction, which contributes to the immunocompromised state of patients with cirrhosis or tumors. PMID:24965775

  1. Connexins in renal endothelial function and dysfunction.

    PubMed

    Abed, Ahmed; Dussaule, Jean-Claude; Boffa, Jean-Jacques; Chatziantoniou, Christos; Chadjichristos, Christos E

    2014-01-01

    The renal endothelium plays a critical role in kidney physiopathology as it is implicated in various processes such as the regulation of vasomotor tone, the control of tissue inflammation and thrombosis. Recent evidence highlights direct implication of renal endothelial dysfunction in the progression of chronic kidney disease. Renal endothelial dysfunction is a multifaceted process in which chemokines, cytokines, prothrombotic factors and adhesion molecules are known to play a crucial role. Apart from paracrine cell-to-cell signaling, the role for gap junction-mediated intercellular communication in renal physiopathology has been recently suggested. Gap junction channels are formed by the hexameric assembly of connexins and directly connect the cytoplasm of adjacent cells. Due to their ability to regulate multiple physiological and pathological signals connexins are currently taking an important place in the list of actors involved in renal endothelial function and dysfunction. In this review we will focus on possible implications of connexins in the physiopathological processes associated with renal vascular endothelium. PMID:24720461

  2. Unilateral diaphragmatic dysfunction in blunt chest trauma.

    PubMed

    Gastinne, H; Venot, J; Dupuy, J P; Gay, R

    1988-03-01

    This study was undertaken to evaluate unilateral diaphragmatic dysfunction within ten days after blunt chest trauma. Thirty patients with unilateral chest injury, or predominantly one-sided injuries, were investigated in the supine position, under analgesia. Right and left hemidiaphragm displacement (DD) was measured, using digital subtraction radiography, during quiet and forced breathing. The diaphragmatic contribution to breathing was determined by rib cage and abdominal circumference measurement changes. In both breathing modes, DD of the injured side was lower than DD of the uninjured side (p less than 0.01, p less than 0.001). Six patients had complete diaphragmatic motionlessness. The inspired air volume due to diaphragmatic motion (Vab) was reduced when compared to normal subjects and Vab/VT ratio was always found to be less than 0.65. The degree of diaphragmatic dysfunction appeared related to injury location and is most severe in injuries of the lower chest which implies direct diaphragm muscle injury, although other mechanisms may be implicated. Diaphragmatic dysfunction can contribute to respiratory failure in these patients, and should be considered. PMID:3277805

  3. Endothelial dysfunction in adipose triglyceride lipase deficiency

    PubMed Central

    Schrammel, Astrid; Mussbacher, Marion; Wölkart, Gerald; Stessel, Heike; Pail, Karoline; Winkler, Sarah; Schweiger, Martina; Haemmerle, Guenter; Al Zoughbi, Wael; Höfler, Gerald; Lametschwandtner, Alois; Zechner, Rudolf; Mayer, Bernd

    2014-01-01

    Systemic knockout of adipose triglyceride lipase (ATGL), the pivotal enzyme of triglyceride lipolysis, results in a murine phenotype that is characterized by progredient cardiac steatosis and severe heart failure. Since cardiac and vascular dysfunction have been closely related in numerous studies we investigated endothelium-dependent and -independent vessel function of ATGL knockout mice. Aortic relaxation studies and Langendorff perfusion experiments of isolated hearts showed that ATGL knockout mice suffer from pronounced micro- and macrovascular endothelial dysfunction. Experiments with agonists directly targeting vascular smooth muscle cells revealed the functional integrity of the smooth muscle cell layer. Loss of vascular reactivity was restored ~ 50% upon treatment of ATGL knockout mice with the PPAR? agonist Wy14,643, indicating that this phenomenon is partly a consequence of impaired cardiac contractility. Biochemical analysis revealed that aortic endothelial NO synthase expression and activity were significantly reduced in ATGL deficiency. Enzyme activity was fully restored in ATGL mice treated with the PPAR? agonist. Biochemical analysis of perivascular adipose tissue demonstrated that ATGL knockout mice suffer from perivascular inflammatory oxidative stress which occurs independent of cardiac dysfunction and might contribute to vascular defects. Our results reveal a hitherto unrecognized link between disturbed lipid metabolism, obesity and cardiovascular disease. PMID:24657704

  4. Erectile Dysfunction and Other Sexual Activity Dysfunctions among Saudi Type 2 Diabetic Patients

    PubMed Central

    AlMogbel, Turki Abdullah

    2014-01-01

    Objectives The aim of the study is to determine the prevalence of Erectile Dysfunction (ED) in Type 2 diabetic Saudi patients, to determine the effect of Type 2 diabetic on other sexual activities (intercourse satisfaction, orgasmic function, sexual desire, overall satisfaction), and to assess whether glycemic control and duration of diabetes have an influence on sexual activities or not. Methods A cross-sectional study was conducted among 376 of Type 2 diabetic male Saudi patients. Erectile dysfunction and other sexual activities dysfunctions were evaluated using the International Index of Erectile Function (IIEF) by a fill coded questionnaire. Additionally, the level of glycosylated hemoglobin was measured to classify the diabetes control status in patients. Results Erectile Dysfunction was reported by 83% of male Saudi diabetic patients. The results show that there was a significant association between the presence of ED and both the age and the duration of diabetes. Family income, occupation, and educational level of the patients show a significant association between them and erectile dysfunction (ED). Moreover, glycemic control did not show a significant association with ED in our sample. Conclusion The findings showed that prevalence of ED among male Saudi diabetic patients is high. It increases with age and duration of diabetes. Also, the study showed that the glycemic control did not correlate with ED. It is recommended that the family physician and diabetologist should ask routinely for this complication in patients with diabetes just like any other diabetes complication. PMID:25780354

  5. dysfunction dysfunction

    E-print Network

    Paris-Sud XI, Université de

    Iron overload Oxygen radicals ISC loss Iron overload ROS hyper sensitivity A B Friedreich's ataxia://www.biomedcentral.com/1741-7015/9/112 (11 October 2011) #12;OPINION Open Access Friedreich's ataxia: the vicious circle Friedreich's ataxia, the most frequent progressive autosomal recessive disorder involving the central

  6. Effect of a 5-HT1A receptor agonist (8-OH-DPAT) on external urethral sphincter activity in a rat model of pudendal nerve injury.

    PubMed

    Chen, Shih-Ching; Cheng, Chen-Li; Fan, Wen-Jia; Chen, Jia-Jin Jason; Lai, Chien-Hung; Peng, Chih-Wei

    2011-07-01

    Although serotonergic agents have been used to treat patients with stress urinary incontinence, the characteristics of the external urethral sphincter (EUS) activity activated by 5-HT receptors have not been extensively studied. This study examined the effects of the 5-HT(1A) receptor agonist, 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), on the EUS-electromyography and resistance of the urethra in a rat model with bilateral pudendal nerve injury (BPNI). Two measurements were utilized to assess the effects of the drug on bladder and urethral functions: the simultaneous recordings of transvesical pressure under isovolumetric conditions [isovolumetric intravesical pressure (IVP)] and urethral perfusion pressure, and the simultaneous recordings of IVP during continuously isotonic transvesical infusion with an open urethra (isotonic IVP) and EUS-electromyography. This study also evaluated the urethral continence using leak point pressure testing. The urethral perfusion pressure and leak point pressure measurements of BPNI rats reveal that 8-OH-DPAT significantly increased urethral resistance during the bladder storage phase, yet decreased resistance during the voiding phase. The entire EUS burst period was significantly prolonged, within which the average silent period increased and the frequency of burst discharges decreased. 8-OH-DPAT also improved the voiding efficiency, as evidenced by the detection of decreases in the contraction amplitude and residual volume, with increases in contraction duration and voided volume. These findings suggest that 8-OH-DPAT not only improved continence function, but also elevated the voiding function in a BPNI rat model. PMID:21490366

  7. Female sexual dysfunction: the important points to remember.

    PubMed

    Pasqualotto, Eleonora B; Pasqualotto, Fabio Firmbach; Sobreiro, Bernardo P; Lucon, Antonio Marmo

    2005-02-01

    Media exposure regarding male sexual dysfunction and the growing number of viable treatment alternatives for erectile dysfunction has resulted in increasing numbers of men seeking clinical appointments and treatment for the condition, which has previously been considered taboo. Because these problems usually arise within the context of relationships, some investigators have alluded to increased rates of sexual dysfunction among the partners of these men. Also, since general practitioners, gynaecologists, geriatrists, and urologists are also seeing female patients for evaluation of various types of dysfunction, certain groups of these women with underlying chronic conditions have been noted to have high rates of concomitant sexual dysfunction. Physicians who have good rapport with these patients are in a privileged position to help with these intimate problems, which are often difficult for patients to discuss. Therefore, it is of extreme importance that these professionals become knowledgeable about and comfortable with the initial evaluation and possible treatment of female sexual dysfunction. PMID:15838582

  8. Small fiber dysfunction predominates in Fabry neuropathy.

    PubMed

    Dütsch, M; Marthol, H; Stemper, B; Brys, M; Haendl, T; Hilz, M J

    2002-12-01

    Fabry disease is an X-linked recessive disease with a reduction of lysosomal alpha galactosidase A and consecutive storage of glycolipids e.g., in the brain, kidney, skin, and nerve fibers. Cardinal neurologic findings are hypohidrosis, painful episodes, and peripheral neuropathy. So far, the neurophysiological findings regarding the extent of large and small fiber dysfunction are contradictory. This study evaluated large and small nerve fiber function in a homogeneous group of Fabry patients. In 24 of 30 Fabry patients with creatinine below 194.7 mmol/L the authors assessed median, ulnar, and peroneal motor conduction velocity (MCV) and median, ulnar, and sural sensory conduction velocity (SCV) nerve conduction to study the function of thickly myelinated nerve fibers. In addition, the authors studied sympathetic skin responses (SSR) at both hands and feet in 24 patients. To evaluate A beta nerve fiber function, the authors determined vibratory detection thresholds (VDT) at the first toe in 30 patients. Function of A delta and C fibers was assessed by quantitative sensory testing of cold detection threshold (CDT) and heat-pain detection thresholds (HPDT). Nerve conduction studies showed significantly decreased amplitudes of MCVs and SCVs in Fabry patients as compared to controls. However, individual results of MCV and SCV studies were only mildly impaired. SSRs were present in all tested patients but SSR amplitudes were significantly decreased in Fabry patients in comparison to controls. VDT, CDT, and HPDT were significantly elevated in Fabry patients as compared to controls. However, only six patients had pathologic VDT, 19 had increased CDT, and 25 had elevated HPDT at a high level of stimulation. In Fabry patients, small fiber dysfunction is more prominent than large fiber dysfunction, confirming previous findings of sural nerve biopsies. The results suggest a higher vulnerability of small-diameter nerve fibers than of the thickly myelinated fibers. PMID:12488789

  9. Function and Dysfunction of Human Sinoatrial Node

    PubMed Central

    Joung, Boyoung

    2015-01-01

    Sinoatrial node (SAN) automaticity is jointly regulated by a voltage (cyclic activation and deactivation of membrane ion channels) and Ca2+ clocks (rhythmic spontaneous sarcoplasmic reticulum Ca2+ release). Using optical mapping in Langendorff-perfused canine right atrium, we previously demonstrated that the ?-adrenergic stimulation pushes the leading pacemaker to the superior SAN, which has the fastest activation rate and the most robust late diastolic intracellular calcium (Cai) elevation. Dysfunction of the superior SAN is commonly observed in animal models of heart failure and atrial fibrillation (AF), which are known to be associated with abnormal SAN automaticity. Using the 3D electroanatomic mapping techniques, we demonstrated that superior SAN served as the earliest atrial activation site (EAS) during sympathetic stimulation in healthy humans. In contrast, unresponsiveness of superior SAN to sympathetic stimulation was a characteristic finding in patients with AF and SAN dysfunction, and the 3D electroanatomic mapping technique had better diagnostic sensitivity than corrected SAN recovery time testing. However, both tests have significant limitations in detecting patients with symptomatic sick sinus syndrome. Recently, we reported that the location of the EAS can be predicted by the amplitudes of P-wave in the inferior leads. The inferior P-wave amplitudes can also be used to assess the superior SAN responsiveness to sympathetic stimulation. Inverted or isoelectric P-waves at baseline that fail to normalize during isoproterenol infusion suggest SAN dysfunction. P-wave morphology analyses may be helpful in determining the SAN function in patients at risk of symptomatic sick sinus syndrome. PMID:26023305

  10. Bicycle riding, perineal trauma, and erectile dysfunction: Data and solutions

    Microsoft Academic Search

    Irwin Goldstein; Alan L. Lurie; John P. Lubisich

    2007-01-01

    Significant clinical and basic science advances in the field of sexual medicine have facilitated investigation of the link\\u000a between endothelial dysfunction and erectile dysfunction. Most sexual medicine practitioners accept the premise that in aging\\u000a men with risk factors such as increased waist circumference, diabetes, hypertension, hypogonadism, hypercholesterolemia, and\\u000a insulin insensitivity, a higher prevalence of erectile dysfunction reflects systemic vasculopathy that

  11. Bicycle riding, perineal trauma, and erectile dysfunction: Data and solutions

    Microsoft Academic Search

    Irwin Goldstein; Alan L. Lurie; John P. Lubisich

    2008-01-01

    Significant clinical and basic science advances in the field of sexual medicine have facilitated investigation of the link\\u000a between endothelial dysfunction and erectile dysfunction. Most sexual medicine practitioners accept the premise that in aging\\u000a men with risk factors such as increased waist circumference, diabetes, hypertension, hypogonadism, hypercholesterolemia, and\\u000a insulin insensitivity, a higher prevalence of erectile dysfunction reflects systemic vasculopathy that

  12. Lower extremity above-knee prosthesis-associated erectile dysfunction

    Microsoft Academic Search

    R Munarriz; H Kulaksizoglu; L Hakim; S Gholami; A Nehra; I Goldstein

    2003-01-01

    Blunt pelvic and perineal trauma has been previously reported to result in site-specific veno-occlusive dysfunction and\\/or site-specific cavernosal artery insufficiency. We herein describe a case of erectile dysfunction in a young previously potent amputee. We postulate that the erectile dysfunction is associated with a newly described form of blunt trauma, that is, site-specific compression from a perineal weight-bearing lower extremity

  13. Treating sexual dysfunction in general practice

    PubMed Central

    Duddle, May; Underwood, Betty

    1976-01-01

    A method of training general practitioners in the treatment of sexual dysfunction is described, using fortnightly seminars at which the doctors discussed the continuing care of their patients. Doctors took on patients presenting in their practices and treated couples together, where possible, using a mixture of insight-directed and behavioural techniques similar to those used by Masters and Johnson (1970). Interviews were reported back to the group which gave advice and support. The doctors, all beginners in this type of work, were able to help substantially 72 per cent of 47 couples treated. PMID:957316

  14. Extrapyramidal dysfunction with cerebral arteriovenous malformations 1

    PubMed Central

    Lobo-Antunes, Joao; Yahr, Melvin D.; Hilal, Sadek K.

    1974-01-01

    Arteriovenous malformations have only rarely been implicated as a cause of basal ganglia dysfunction. In four instances where such a lesion was uncovered, abnormal involuntary movements were present. In two, tremor involving the contralateral limbs occurred, while in others the head and neck were involved in dystonic movements and posture. The clinical and angiographic characteristics of these four patients have been assessed and are presented in detail in this report. The possible mechanism by which arteriovenous malformations may disturb the internal circuitry of the basal ganglia and induce symptoms are discussed. Images PMID:4829531

  15. Molecular Links between Mitochondrial Dysfunctions and Schizophrenia

    PubMed Central

    Park, Cana; Park, Sang Ki

    2012-01-01

    Schizophrenia is a complex neuropsychiatric disorder with both neurochemical and neurodevelopmental components in the pathogenesis. Growing pieces of evidence indicate that schizophrenia has pathological components that can be attributable to the abnormalities of mitochondrial function, which is supported by the recent finding suggesting mitochondrial roles for Disrupted-in-Schizophrenia 1 (DISC1). In this minireview, we briefly summarize the current understanding of the molecular links between mitochondrial dysfunctions and the pathogenesis of schizophrenia, covering recent findings from human genetics, functional genomics, proteomics, and molecular and cell biological approaches. PMID:22358509

  16. Tear Dysfunction and the Cornea: LXVII Edward Jackson Memorial Lecture

    PubMed Central

    Pflugfelder, Stephen C.

    2011-01-01

    Purpose To describe the cause and consequence of tear dysfunction related corneal disease. Design Perspective on effects of tear dysfunction on the cornea Methods Evidence is presented on the effects of tear dysfunction on corneal morphology, function and health, as well as efficacy of therapies for tear dysfunction related corneal disease. Results Tear dysfunction is a prevalent eye disease and the most frequent cause for superficial corneal epithelial disease that results in corneal barrier disruption, an irregular optical surface, light scattering, optical aberrations and exposure and sensitization of pain sensing nerve endings (nociceptors). Tear dysfunction related corneal disease causes irritation and visual symptoms, such as photophobia, blurred and fluctuating vision that may decrease quality of life. Dysfunction of one or more components of the lacrimal functional unit results in changes in tear composition, including elevated osmolarity and increased concentrations of matrix metalloproteinases, inflammatory cytokines and chemokines. These tear compositional changes promote disruption of tight junctions, alter differentiation and accelerate death of corneal epithelial cells. Conclusions Corneal epithelial disease resulting from tear dysfunction causes eye irritation and decreases visual function. Clinical and basic research has improved understanding of the pathogenesis of tear dysfunction related corneal epithelial disease, as well as treatment outcomes. PMID:22019306

  17. Hematopoietic transcription factor mutations and inherited platelet dysfunction

    PubMed Central

    Songdej, Natthapol

    2015-01-01

    The molecular and genetic mechanisms in most patients with inherited platelet dysfunction are unknown. There is increasing evidence that mutations in hematopoietic transcription factors are major players in the pathogenesis of defective megakaryopoiesis and platelet dysfunction in patients with inherited platelet disorders. These hematopoietic transcription factors include RUNX1, FLI1, GATA-1, and GFI1B. Mutations involving these transcription factors affect diverse aspects of platelet production and function at the genetic and molecular levels, culminating in clinical manifestations of thrombocytopenia and platelet dysfunction. This review focuses on these hematopoietic transcription factors in the pathobiology of inherited platelet dysfunction.

  18. Induratio penis plastica--a factor of erectile dysfunction?

    PubMed

    Werner, W; Wunderlich, H; Schubert, J

    1996-01-01

    There are still diverse management options in Peyronie's disease and diverse opinions about the coincidence of Peyronie's disease and erectile dysfunction as well. The connection between Peyronie's disease and ED has been proved by some papers but on the other hand authors have refused to accept this claim. We have found erectile dysfunction in about 30% of our patients. We investigated 61 patients with Peyronie's disease. As diagnostic criteria assessment of angulation and erectile dysfunction are proposed. The tunica albuginea plication technique was used in 35 patients with good results. In our investigation we did not find any coincidence of Peyronie's disease with erectile dysfunction. PMID:8899481

  19. Female sexual dysfunction, voiding symptoms and depression: common findings in partners of men with erectile dysfunction.

    PubMed

    Shabsigh, Ridwan; Anastasiades, Aristotelis; Cooper, Kimberly L; Rutman, Matthew P

    2006-12-01

    The aim of this study was to investigate the prevalence of female sexual dysfunction (FSD), urinary symptoms, and depressive symptoms in female partners of men presenting with erectile dysfunction (ED). A multi-component questionnaire was administered to female partners of men with erectile dysfunction presenting to a urology center. It contained a standardized sexual function component (the Brief Index of Sexual Function for Women), a depression scale (Centers for Epidemiologic Studies-Depression, CES-D), a demographics questionnaire and a general medical questionnaire. A total of 73 consecutive female partners of male patients presenting with ED, were surveyed using the questionnaire at their counterpart's visit. Fifty-two women responded, of whom 50 filled out the questionnaire adequately for proper evaluation. This indicated a response rate of 68% (50/73). The mean age was 44.8 years (range 20.0-83.0). Thirty-eight of the 50 women (76%) reported being sexually active. A variety of sexual behaviors were reported including 40% (20/50) of women engaging in vaginal intercourse. Sexual dysfunction symptoms included: anxiety/inhibition (26%), hypoactive desire (20%), arousal/lubrication difficulty (30%), orgasmic difficulty (24%), dyspareunia (18%), incontinence during intercourse (8%), and sexual dissatisfaction (34%). Eight women (16%) reported difficulty communicating sexual issues with their partners. Forty-one women (82%) rated sexual activity as an important part of their lives. Urinary symptoms of frequency and urgency were reported by 18/50 (36%). Depressive symptoms were present in 22/50 (44%). FSD disorders, urinary symptoms and depressive symptoms are common in partners of men with erectile dysfunction. PMID:17082939

  20. Pelvic floor and sexual male dysfunction.

    PubMed

    Pischedda, Antonella; Fusco, Ferdinando; Curreli, Andrea; Grimaldi, Giovanni; Pirozzi Farina, Furio

    2013-03-01

    The pelvic floor is a complex multifunctional structure that corresponds to the genito-urinary-anal area and consists of muscle and connective tissue. It supports the urinary, fecal, sexual and reproductive functions and pelvic statics. The symptoms caused by pelvic floor dysfunction often affect the quality of life of those who are afflicted, worsening significantly more aspects of daily life. In fact, in addition to providing support to the pelvic organs, the deep floor muscles support urinary continence and intestinal emptying whereas the superficial floor muscles are involved in the mechanism of erection and ejaculation. So, conditions of muscle hypotonia or hypertonicity may affect the efficiency of the pelvic floor, altering both the functionality of the deep and superficial floor muscles. In this evolution of knowledge it is possible imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life. PMID:23695397

  1. Mitochondrial Disorders of DNA Polymerase ? Dysfunction

    PubMed Central

    Zhang, Linsheng; Chan, Sherine S. L.; Wolff, Daynna J.

    2011-01-01

    Context Primary mitochondrial dysfunction is one of the most common causes of inherited disorders predominantly involving the neuromuscular system. Advances in the molecular study of mitochondrial DNA have changed our vision and our approach to primary mitochondrial disorders. Many of the mitochondrial disorders are caused by mutations in nuclear genes and are inherited in an autosomal recessive pattern. Among the autosomal inherited mitochondrial disorders, those related to DNA polymerase ? dysfunction are the most common and the best studied. Understanding the molecular mechanisms and being familiar with the recent advances in laboratory diagnosis of this group of mitochondrial disorders are essential for pathologists to interpret abnormal histopathology and laboratory results and to suggest further studies for a definitive diagnosis. Objectives To help pathologists better understand the common clinical syndromes originating from mutations in DNA polymerase ? and its associated proteins and use the stepwise approach of clinical, laboratory, and pathologic diagnosis of these syndromes. Data Sources Review of pertinent published literature and relevant Internet databases. Conclusions Mitochondrial disorders are now better recognized with the development of molecular tests for clinical diagnosis. A cooperative effort among primary physicians, diagnostic pathologists, geneticists, and molecular biologists with expertise in mitochondrial disorders is required to reach a definitive diagnosis. PMID:21732785

  2. Telomere dysfunction causes alveolar stem cell failure

    PubMed Central

    Alder, Jonathan K.; Barkauskas, Christina E.; Limjunyawong, Nathachit; Stanley, Susan E.; Kembou, Frant; Tuder, Rubin M.; Hogan, Brigid L. M.; Mitzner, Wayne; Armanios, Mary

    2015-01-01

    Telomere syndromes have their most common manifestation in lung disease that is recognized as idiopathic pulmonary fibrosis and emphysema. In both conditions, there is loss of alveolar integrity, but the underlying mechanisms are not known. We tested the capacity of alveolar epithelial and stromal cells from mice with short telomeres to support alveolar organoid colony formation and found that type 2 alveolar epithelial cells (AEC2s), the stem cell-containing population, were limiting. When telomere dysfunction was induced in adult AEC2s by conditional deletion of the shelterin component telomeric repeat-binding factor 2, cells survived but remained dormant and showed all the hallmarks of cellular senescence. Telomere dysfunction in AEC2s triggered an immune response, and this was associated with AEC2-derived up-regulation of cytokine signaling pathways that are known to provoke inflammation in the lung. Mice uniformly died after challenge with bleomycin, underscoring an essential role for telomere function in AEC2s for alveolar repair. Our data show that alveoloar progenitor senescence is sufficient to recapitulate the regenerative defects, inflammatory responses, and susceptibility to injury that are characteristic of telomere-mediated lung disease. They suggest alveolar stem cell failure is a driver of telomere-mediated lung disease and that efforts to reverse it may be clinically beneficial. PMID:25840590

  3. Male erectile dysfunction: therapy and drug delivery.

    PubMed

    Chattaraj, S

    2001-06-01

    Finding an ideal chemical agent or a user-friendly delivery system for the treatment of male erectile dysfunction (MED) has been the goal of several research groups. The most suitable therapy for erectile dysfunction (ED) in man would involve a chemical that acts directly or indirectly on the penis and assures erection without any side effects. The understanding of ED has grown tremendously over the last decade and has been accompanied by an impressive proliferation of new therapies, ranging from traditional therapeutic agents to novel agents and drug delivery systems. Before Viagra, the most effective therapies involved injecting drugs directly into the base of the penis and inserting suppositories into the urethra, but these were too invasive to achieve great popularity. Although ED was not an area of pharmaceutical research that many companies were focused on, the success of Viagra has shown that there is a huge market opportunity for this indication. Financial analysts project a worldwide market of approximately $2 billion for oral ED treatments. This review presents a general overview of the present state as well as the future directions of research to treat MED. PMID:16001313

  4. Pulmonary particulate matter and systemic microvascular dysfunction.

    PubMed

    Nurkiewicz, Timothy R; Porter, Dale W; Hubbs, Ann F; Stone, Samuel; Moseley, Amy M; Cumpston, Jared L; Goodwill, Adam G; Frisbee, Stephanie J; Perrotta, Peter L; Brock, Robert W; Frisbee, Jefferson C; Boegehold, Matthew A; Frazer, David G; Chen, Bean T; Castranova, Vincent

    2011-12-01

    Pulmonary particulate matter (PM) exposure has been epidemiologically associated with an increased risk of cardiovascular morbidity and mortality, but the mechanistic foundations for this association are unclear. Exposure to certain types of PM causes changes in the vascular reactivity of several macrovascular segments. However, no studies have focused upon the systemic microcirculation, which is the primary site for the development of peripheral resistance and, typically, the site of origin for numerous pathologies. Ultrafine PM--also referred to as nanoparticles, which are defined as ambient and engineered particles with at least one physical dimension less than 100 nm (Oberdorster et al. 2005)--has been suggested to be more toxic than its larger counterparts by virtue of a larger surface area per unit mass. The purpose of this study was fourfold: (1) determine whether particle size affects the severity of postexposure microvascular dysfunction; (2) characterize alterations in microvascular nitric oxide (NO) production after PM exposure; (3) determine whether alterations in microvascular oxidative stress are associated with NO production, arteriolar dysfunction, or both; and (4) determine whether circulating inflammatory mediators, leukocytes, neurologic mechanisms, or a combination of these play a fundamental role in mediating pulmonary PM exposure and peripheral microvascular dysfunction. To achieve these goals, we created an inhalation chamber that generates stable titanium dioxide (TiO2) aerosols at concentrations up to 20 mg/m3. TiO2 is a well-characterized particle devoid of soluble metals. Sprague Dawley and Fischer 344 (F-344) rats were exposed to fine or nano-TiO2 PM (primary count modes of approximately 710 nm and approximately 100 nm in diameter, respectively) at concentrations of 1.5 to 16 mg/m3 for 4 to 12 hours to produce pulmonary loads of 7 to 150 microg in each rat. Twenty-four hours after pulmonary exposure, the following procedures were performed: the spinotrapezius muscle was prepared for in vivo microscopy, blood samples were taken from an arterial line, and various tissues were harvested for histologic and immunohistochemical analyses. Some rats received a bolus dose of cyclophosphamide 3 days prior to PM exposure to deplete circulating neutrophils and bronchoalveolar lavage (BAL) was performed in separate groups of rats exposed to identical TiO2 loads. No significant differences in BAL fluid composition based on PM size or load were found in these rats. Plasma levels of interleukin (IL)-2, IL-18, IL-13, and growth-related oncogene (GRO) (also known as keratinocyte-derived-chemokine [KC]) were altered after PM exposure. In rats exposed to fine TiO2, endothelium-dependent arteriolar dilation was significantly decreased, and this dysfunction was robustly augmented in rats exposed to nano-TiO2. This effect was not related to an altered smooth-muscle responsiveness to NO because arterioles in both groups dilated comparably in response to the NO donor sodium nitroprusside (SNP). Endogenous microvascular NO production was similarly decreased after inhalation of either fine or nano-TiO2 in a dose-dependent manner. Microvascular oxidative stress was significantly increased among both exposure groups. Furthermore, treatment with antioxidants (2,2,6,6-tetramethylpiperdine-N-oxyl [TEMPOL] plus catalase), the myeloperoxidase (MPO) inhibitor 4-aminobenzoic hydrazide (ABAH), or the nicotinamide adenine dinucleotide phosphate oxidase (NADPH oxidase) inhibitor apocynin partially restored NO production and normalized arteriolar function in both groups. Neutrophil depletion restored dilation in PM-exposed rats by as much as 42%. Coincubation of the spinotrapezius muscle with the fast sodium (Na+) channel antagonist tetrodotoxin (TTX) restored arteriolar dilation by as much as 54%, suggesting that sympathetic neural input may be affected by PM exposure. The results of these experiments indicate that (1) the size of inhaled PM dictates the intensity of systemic microvascular dysfunction; (2) this arteriolar dysfuncti

  5. Different in vitro and in vivo profiles of substituted 3-aminopropylphosphinate and 3-aminopropyl(methyl)phosphinate GABAB receptor agonists as inhibitors of transient lower oesophageal sphincter relaxation

    PubMed Central

    Lehmann, A; Antonsson, M; Aurell-Holmberg, A; Blackshaw, LA; Brändén, L; Elebring, T; Jensen, J; Kärrberg, L; Mattsson, JP; Nilsson, K; Oja, SS; Saransaari, P; von Unge, S

    2012-01-01

    BACKGROUND AND PURPOSE Gastro-oesophageal reflux is predominantly caused by transient lower oesophageal sphincter relaxation (TLOSR) and GABAB receptor stimulation inhibits TLOSR. Lesogaberan produces fewer CNS side effects than baclofen, which has been attributed to its affinity for the GABA transporter (GAT), the action of which limits stimulation of central GABAB receptors. To understand the structure–activity relationship for analogues of lesogaberan (3-aminopropylphosphinic acids), and corresponding 3-aminopropyl(methyl)phosphinic acids, we have compared representatives of these classes in different in vitro and in vivo models. EXPERIMENTAL APPROACH The compounds were characterized in terms of GABAB agonism in vitro. Binding to GATs and cellular uptake was done using rat brain membranes and slices respectively. TLOSR was measured in dogs, and CNS side effects were evaluated as hypothermia in mice and rats. KEY RESULTS 3-Aminopropylphosphinic acids inhibited TLOSR with a superior therapeutic index compared to 3-aminopropyl(methyl)phosphinic acids. This difference was most likely due to differential GAT-mediated uptake into brain cells of the former but not latter. In agreement, 3-aminopropyl(methyl)phosphinic acids were much more potent in producing hypothermia in rats even when administered i.c.v. CONCLUSIONS AND IMPLICATIONS An enhanced therapeutic window for 3-aminopropylphosphinic acids compared with 3-aminopropyl(methyl)phosphinic acids with respect to inhibition of TLOSR was observed and is probably mechanistically linked to neural cell uptake of the former but not latter group of compounds. These findings offer a platform for discovery of new GABAB receptor agonists for the treatment of reflux disease and other conditions where selective peripheral GABAB receptor agonism may afford therapeutic effects. PMID:21950457

  6. An MRI-Based Dose-Response Analysis of Urinary Sphincter Dose and Urinary Morbidity after Brachytherapy for Prostate Cancer in a Phase II Prospective Trial

    PubMed Central

    Register, Steven P.; Kudchadker, Rajat J.; Levy, Larry; Swanson, David A.; Pugh, Thomas J.; Bruno, Teresa L.; Frank, Steven J.

    2013-01-01

    Purpose To compare dose-volume histogram (DVH) variables for the internal and external urinary sphincters (IUS/EUS) with urinary quality of life after prostate brachytherapy. Materials and Methods Subjects were 42 consecutive men from a prospective study of brachytherapy as monotherapy with 125I for intermediate-risk localized prostate cancer. No patient received hormone therapy. Preplanning constraints included prostate V100 >95%, V150 <60%, and V200 <20% and rectal R100 < 1 cm3. Patients completed the EPIC quality of life questionnaire before and 1, 4, 8, and 12 months after implantation, and urinary domain scores were analyzed. All structures including the IUS and EUS were contoured on T2-weighted MRI at day 30, and doses received were calculated from identification of seeds on CT. Spearman's (nonparametric) rank correlation coefficient (?) was used for statistical analyses. Results Overall urinary morbidity was worst 1 month after the implant. Urinary function declined when the IUS V285 was 0.4% (? =–0.32, p=0.04); bother worsened when the IUS V35 was 99% (?=–0.31, p=0.05) or the EUS V240 was 63% (?=–0.31, p=0.05); irritation increased when the IUS V35 was 95% (?=–0.37, p=0.02) and the EUS V265 was 24% (?=–0.32, p=0.04); and urgency worsened when the IUS V35 was 99.5% (?=–0.38, p=0.02). Incontinence did not correlate with EUS or IUS dose Conclusions Doses to the IUS and EUS on MRI/CT predicted worse urinary function, with greater bother, irritative symptoms, and urgency. Incorporating MRI-based DVH analysis into the treatment planning process may reduce acute urinary morbidity after brachytherapy. PMID:23466360

  7. Correlation in Rectal Cancer Between Clinical Tumor Response After Neoadjuvant Radiotherapy and Sphincter or Organ Preservation: 10-Year Results of the Lyon R 96-02 Randomized Trial

    SciTech Connect

    Ortholan, Cecile [Department of Radiation Oncology, Antoine Lacassagne Cancer Center, Nice, UNSA (Universite de Nice Sophia-Antipolis) (France); Department of Oncology-Radiotherapy, Hopital Princesse Grace, Monaco (France); Romestaing, Pascale [Hopital Prive Jean Mermoz, Lyon (France); Chapet, Olivier [Department of Radiation Oncology, Lyon Sud University Hospital, Hospices Civils de Lyon, Lyon (France); Gerard, Jean Pierre, E-mail: jean-pierre.gerard@nice.unicancer.fr [Department of Radiation Oncology, Antoine Lacassagne Cancer Center, Nice, UNSA (Universite de Nice Sophia-Antipolis) (France)

    2012-06-01

    Purpose: To investigate, in rectal cancer, the benefit of a neoadjuvant radiation dose escalation with endocavitary contact radiotherapy (CXRT) in addition to external beam radiotherapy (EBRT). This article provides an update of the Lyon R96-02 Phase III trial. Methods and Materials: A total of 88 patients with T2 to T3 carcinoma of the lower rectum were randomly assigned to neoadjuvant EBRT 39 Gy in 13 fractions (43 patients) vs. the same EBRT with CXRT boost, 85 Gy in three fractions (45 patients). Median follow-up was 132 months. Results: The 10-year cumulated rate of permanent colostomy (CRPC) was 63% in the EBRT group vs. 29% in the EBRT+CXRT group (p < 0.001). The 10-year rate of local recurrence was 15% vs. 10% (p = 0.69); 10-year disease-free survival was 54% vs. 53% (p = 0.99); and 10-year overall survival was 56% vs. 55% (p = 0.85). Data of clinical response (CR) were available for 78 patients (36 in the EBRT group and 42 in the EBRT+CXRT group): 12 patients were in complete CR (1 patient vs. 11 patients), 53 patients had a CR {>=}50% (24 patients vs. 29 patients), and 13 patients had a CR <50% (11 patients vs. 2 patients) (p < 0.001). Of the 65 patients with CR {>=}50%, 9 had an organ preservation procedure (meaning no rectal resection) taking advantage of major CR. The 10-year CRPC was 17% for patients with complete CR, 42% for patients with CR {>=}50%, and 77% for patients with CR <50% (p = 0.014). Conclusion: In cancer of the lower rectum, CXRT increases the complete CR, turning in a significantly higher rate of long-term permanent sphincter and organ preservation.

  8. Uncoupled Cardiac Nitric Oxide Synthase Mediates Diastolic Dysfunction

    PubMed Central

    Silberman, Gad A.; Fan, Tai-Hwang M.; Liu, Hong; Jiao, Zhe; Xiao, Hong D.; Lovelock, Joshua D.; Boulden, Beth M.; Widder, Julian; Fredd, Scott; Bernstein, Kenneth E.; Wolska, Beata M.; Dikalov, Sergey; Harrison, David G.; Dudley, Samuel C.

    2010-01-01

    Background Heart failure with preserved ejection fraction is one consequence of hypertension and caused by impaired cardiac diastolic relaxation. Nitric oxide (NO) is a known modulator of cardiac relaxation. Hypertension can lead to a reduction in vascular NO, in part because nitric oxide synthase (NOS) becomes uncoupled when oxidative depletion of its co-factor tetrahydrobiopterin (BH4) occurs.Similar events may occur in the heart leading to uncoupled NOS and diastolic dysfunction. Methods and Results In a hypertensive mouse model, diastolic dysfunction was accompanied by cardiac oxidation, a reduction in cardiac BH4, and uncoupled NOS. Compared to sham-operated animals, male mice with unilateral nephrectomy, with subcutaneous implantation of a controlled release deoxycorticosterone acetate (DOCA) pellet, and given 1% saline to drink were mildly hypertensive and had diastolic dysfunction in the absence of systolic dysfunction or cardiac hypertrophy. The hypertensive mouse hearts showed increased oxidized biopterins, NOS-dependent superoxide production, reduced NO production, and phosphorylated phospholamban. Feeding hypertensive mice BH4 (5 mg/day), but not treating with hydralazine or tetrahydroneopterin, improved cardiac BH4 stores, phosphorylated phospholamban levels, and diastolic dysfunction. Isolated cardiomyocyte experiments revealed impaired relaxation that was normalized with acute BH4 treatment. Targeted cardiac overexpression of angiotensin converting enzyme also resulted in cardiac oxidation, NOS uncoupling, and diastolic dysfunction in the absence of hypertension. Conclusions Cardiac oxidation, independent of vascular changes, can lead to uncoupled cardiac NOS and diastolic dysfunction. BH4 may represent a possible treatment for diastolic dysfunction. PMID:20083682

  9. Sacroiliac dysfunction in dancers with low back pain

    Microsoft Academic Search

    L. E. DeMann

    1997-01-01

    SUMMARY. Low back pain is a common occurrence in dancers. Studies have shown its prevalence to be around 12% of all dance type of injuries. It is commonly thought by health professionals who specialize in dance medicine that sacroiliac (SI) dysfunction is one of the more common causes of low back pain in dancers. The aetiology of SI dysfunction in

  10. Telomere Dysfunction Increases Mutation Rate and Genomic Instability

    Microsoft Academic Search

    Jennifer A. Hackett; David M. Feldser; Carol W. Greider

    2001-01-01

    The increased tumor incidence in telomerase null mice suggests that telomere dysfunction induces genetic instability. To test this directly, we examined mutation rate in the absence of telomerase in S. cerevisiae. The mutation rate in the CAN1 gene increased 10- to 100-fold in est1? strains as telomeres became dysfunctional. This increased mutation rate resulted from an increased frequency of terminal

  11. Telomere dysfunction provokes regional amplification and deletion in cancer genomes

    Microsoft Academic Search

    Rónán C. O'Hagan; Sandy Chang; Richard S. Maser; Ramya Mohan; Steven E. Artandi; Lynda Chin; Ronald A. DePinho

    2002-01-01

    Telomere dysfunction and associated fusion-breakage in the mouse encourages epithelial carcinogenesis and a more humanized genomic profile that includes nonreciprocal translocations (NRTs). Here, array comparative genomic hybridization was used to determine the pathogenic significance of NRTs and to determine whether telomere dysfunction also drives amplifications and deletions of cancer-relevant loci. Compared to tumors arising in mice with intact telomeres, tumors

  12. Stroke: Bowel Dysfunction in Patients Admitted for Rehabilitation§

    PubMed Central

    Engler, Tânia M.N. de M; Dourado, Cinthia C; Amâncio, Thais G; Farage, Luciano; de Mello, Paulo A.; Padula, Marcele P.C

    2014-01-01

    Aim : to assess the prevalence of diminished frequency of bowel movements, lumpy or hard stools, intestinal constipation, straining, incomplete evacuation, incontinence (bowel dysfunctions) in patients with brain injury resulting from cerebrovascular accident, either self-reported or reported by their caregivers; to describe the type and frequency of such dysfunctions; and the prevalence of laxative use both before and after stroke. Method : cross-sectional study with 98 hospitalized patients admitted for rehabilitation between December 2009 and May 2010. Results : the prevalence of bowel dysfunctions before stroke was 23.96% whereas after the lesion it was 55.21% (p<0.0001). As reported by patients/caregivers, the chances of developing bowel dysfunctions increase sevenfold after stroke, 95% CI (2.44-24.26). The most frequent dysfunctions before stroke were intestinal constipation (73.91%) and diminished frequency of bowel movements (17.39%). After stroke, constipation remains to be the most frequent dysfunction reported (50%), followed by diminished frequency of bowel movements (26.79%), incomplete evacuation (12.50%), and lack of privacy (5.36%). The use of laxatives was 19,15% after the lesion, but not statisticaly significant (p=0.0736). Conclusion : Bowel dysfunctions increases significantly after stroke. Therefore, further studies are needed to better understand and characterize such dysfunctions, which are scarcely described in the literature. PMID:25419252

  13. Sexual Dysfunction in Males: Significance of Adverse Childhood Experiences.

    ERIC Educational Resources Information Center

    Kinzl, Johann F.; And Others

    1996-01-01

    A survey of 301 male college students found that occasional sexual dysfunction was frequent in young male adults, and long-lasting adverse familial relationships to attachment figures were more influential in later sexual dysfunction than were childhood sexual abuse experiences. (Author/DB)

  14. The relationship between cognitive dysfunction and coping abilities in schizophrenia

    Microsoft Academic Search

    Kelly E. Wilder-Willis; Paula K. Shear; John J. Steffen; Joyce Borkin

    2002-01-01

    Cognitive dysfunction is a core feature of schizophrenia [Psychiatr. Clin. North Am., 16 (1993) 295; Psychopharmacology: The fourth generation of progress, Raven Press, New York (1995) 1171; Clinical Neuropsychology, Oxford University Press, New York (1993) 449] and is related to psychosocial functioning in this population [Am. J. Psychiatry, 153 (1996) 321]. It is unclear whether cognitive dysfunction is related to

  15. Postprandial recruitment of neutrophils may contribute to endothelial dysfunction

    Microsoft Academic Search

    A. J. H. H. M. van Oostrom; T. P. Sijmonsma; C. Verseyden; E. H. J. M. Jansen; E. J. P de Koning; T. J. Rabelink; M. Castro Cabezas

    2003-01-01

    Atherosclerosis is a low-grade inflammatory dis- ease involving leukocytes, lipids, and glucose leading to en- dothelial dysfunction. Since activation of neutrophils by triglycerides and glucose has been described in vitro, we hy- pothesized that the postprandial phase is an inflammatory state affecting leukocytes, possibly contributing to endothelial dysfunction. We measured postprandial blood leukocyte counts, cytokines, hydroperoxides (HPOs), and flow-medi- ated

  16. BRAIN THEORY AND MINIMAL BRAIN DYSFUNCTION * M. S. Gazzaniga

    E-print Network

    Gazzaniga, Michael

    BRAIN THEORY AND MINIMAL BRAIN DYSFUNCTION * M. S. Gazzaniga Department of Graduate Psychology New labeled the diffuse problems of learning disabilities in children as results of minimal brain dysfunction on cerebral functions offered by studying the bisected brain may apply to specific problems seen in some cases

  17. Disconnection as a Mechanism for Cognitive Dysfunction in Multiple Sclerosis

    ERIC Educational Resources Information Center

    Dineen, R. A.; Vilisaar, J.; Hlinka, J.; Bradshaw, C. M.; Morgan, P. S.; Constantinescu, C. S.; Auer, D. P.

    2009-01-01

    Disconnection of cognitively important processing regions by injury to the interconnecting white matter provides a potential mechanism for cognitive dysfunction in multiple sclerosis. The contribution of tract-specific white matter injury to dysfunction in different cognitive domains in patients with multiple sclerosis has not previously been…

  18. Development of motor system dysfunction following whiplash injury

    Microsoft Academic Search

    Michele Sterling; Gwendolen Jullsupasu; Bill Vicenzino; Justin Kenardy; Ross Darnell

    2003-01-01

    Dysfunction in the motor system is a feature of persistent whiplash associated disorders. Little is known about motor dysfunction in the early stages following injury and of its progress in those persons who recover and those who develop persistent symptoms. This study measured prospectively, motor system function (cervical range of movement (ROM), joint position error (JPE) and activity of the

  19. Hidden consequences of olfactory dysfunction: a patient report series

    PubMed Central

    2013-01-01

    Background The negative consequences of olfactory dysfunction for the quality of life are not widely appreciated and the condition is therefore often ignored or trivialized. Methods 1,000 patients with olfactory dysfunction participated in an online study by submitting accounts of their subjective experiences of how they have been affected by their condition. In addition, they were given the chance to answer 43 specific questions about the consequences of their olfactory dysfunction. Results Although there are less practical problems associated with impaired or distorted odor perception than with impairments in visual or auditory perception, many affected individuals report experiencing olfactory dysfunction as a debilitating condition. Smell loss-induced social isolation and smell loss-induced anhedonia can severely affect quality of life. Conclusions Olfactory dysfunction is a serious condition for those affected by it and it deserves more attention from doctors who treat affected patients as well as from scientist who research treatment options. PMID:23875929

  20. Case Report: Persistent erectile dysfunction in a man with prolactinoma

    PubMed Central

    Badal, Justin; Ramasamy, Ranjith; Hakky, Tariq; Chandrashekar, Aravind; Lipshultz, Larry

    2015-01-01

    Erectile dysfunction has been explored as a condition secondary to elevated prolactin; however, the mechanisms by which elevated prolactin levels cause erectile dysfunction have not yet been clearly established. We here present a patient with a history of prolactinoma who suffered from persistent erectile dysfunction despite testosterone supplementation and pharmacological and surgical treatment for the prolactinoma.  Patients who have had both prolactinemia and erectile dysfunction have been reported in the literature, but we find no report of a patient with persistent erectile dysfunction in the setting of testosterone supplementation and persistent hyperprolactinemia refractory to treatment. This case provides evidence supporting the idea that suppression of erectile function occurs in both the central and peripheral nervous systems independent of the hypothalamic-pituitary-gonadal axis. PMID:25844161

  1. Case Report: Persistent erectile dysfunction in a man with prolactinoma.

    PubMed

    Badal, Justin; Ramasamy, Ranjith; Hakky, Tariq; Chandrashekar, Aravind; Lipshultz, Larry

    2015-01-01

    Erectile dysfunction has been explored as a condition secondary to elevated prolactin; however, the mechanisms by which elevated prolactin levels cause erectile dysfunction have not yet been clearly established. We here present a patient with a history of prolactinoma who suffered from persistent erectile dysfunction despite testosterone supplementation and pharmacological and surgical treatment for the prolactinoma.  Patients who have had both prolactinemia and erectile dysfunction have been reported in the literature, but we find no report of a patient with persistent erectile dysfunction in the setting of testosterone supplementation and persistent hyperprolactinemia refractory to treatment. This case provides evidence supporting the idea that suppression of erectile function occurs in both the central and peripheral nervous systems independent of the hypothalamic-pituitary-gonadal axis. PMID:25844161

  2. Management of erectile dysfunction in hypertension: Tips and tricks

    PubMed Central

    Viigimaa, Margus; Vlachopoulos, Charalambos; Lazaridis, Antonios; Doumas, Michael

    2014-01-01

    Arterial hypertension is a major risk factor for cardiovascular disease and affects approximately one third of the adult population worldwide. The vascular origin of erectile dysfunction is now widely accepted in the vast majority of cases. Erectile dysfunction is frequently encountered in patients with arterial hypertension and greatly affects their quality of life of hypertensive patients and their sexual partners. Therefore, the management of erectile dysfunction in hypertensive patients is of paramount importance. Unfortunately, erectile dysfunction remains under-reported, under-recognized, and under-treated in hypertensive patients, mainly due to the lack of familiarity with this clinical entity by treating physicians. This review aims to discuss the more frequent problems in the management of hypertensive patients with erectile dysfunction and propose ways to overcome these problems in everyday clinical practice. PMID:25276292

  3. [HIV-1 associated autonomic dysfunction (HIVAD)].

    PubMed

    Malessa, R; Ohrmann, P; Agelink, M W; Brockmeyer, N H; Diener, H C

    1996-02-01

    In a controlled prospective study we used peripheral autonomic surface potentials (PASP) and an autonomic test battery (valsalva, 30:15 ratio, deep breathing, sustained handgrip, Schellong test) to evaluate HIV-1 associated autonomic dysfunction (HIVAD) in 38 HIV-seropositive patients. Criteria of exclusion were drug or alcohol abuse, concurrent infections, neoplasms, wasting syndrome and neurotoxic medication. We found increased PASP onset latencies and lower PASP amplitudes even in asymptomatic HIV-infected patients (p < 0.0125, Bonferroni corrected p-value). A mild or marked HIVAD was detected in 21% of the patients each. Heart rate and blood pressure responses were similarly affected. HIVAD was not related to HIV-1 associated changes in sural and tibial nerve conduction parameters. Our data suggest that HIVAD is a frequent complication of HIV-1 infection and that HIV-1 plays a direct role in its pathogenesis. Sympathetic and parasympathetic divisions of the ANS appear to be similarly affected. PMID:8851296

  4. Protein carbonylation, cellular dysfunction, and disease progression

    PubMed Central

    Dalle-Donne, Isabella; Aldini, Giancarlo; Carini, Marina; Colombo, Roberto; Rossi, Ranieri; Milzani, Aldo

    2006-01-01

    Carbonylation of proteins is an irreversible oxidative damage, often leading to a loss of protein function, which is considered a widespread indicator of severe oxidative damage and disease-derived protein dysfunction. Whereas moderately carbonylated proteins are degraded by the proteasomal system, heavily carbonylated proteins tend to form high-molecular-weight aggregates that are resistant to degradation and accumulate as damaged or unfolded proteins. Such aggregates of carbonylated proteins can inhibit proteasome activity. A large number of neurodegenerative diseases are directly associated with the accumulation of proteolysis-resistant aggregates of carbonylated proteins in tissues. Identification of specific carbonylated protein(s) functionally impaired and development of selective carbonyl blockers should lead to the definitive assessment of the causative, correlative or consequential role of protein carbonylation in disease onset and/or progression, possibly providing new therapeutic aproaches. PMID:16796807

  5. Biomarkers of postoperative delirium and cognitive dysfunction

    PubMed Central

    Androsova, Ganna; Krause, Roland; Winterer, Georg; Schneider, Reinhard

    2015-01-01

    Elderly surgical patients frequently experience postoperative delirium (POD) and the subsequent development of postoperative cognitive dysfunction (POCD). Clinical features include deterioration in cognition, disturbance in attention and reduced awareness of the environment and result in higher morbidity, mortality and greater utilization of social financial assistance. The aging Western societies can expect an increase in the incidence of POD and POCD. The underlying pathophysiological mechanisms have been studied on the molecular level albeit with unsatisfying small research efforts given their societal burden. Here, we review the known physiological and immunological changes and genetic risk factors, identify candidates for further studies and integrate the information into a draft network for exploration on a systems level. The pathogenesis of these postoperative cognitive impairments is multifactorial; application of integrated systems biology has the potential to reconstruct the underlying network of molecular mechanisms and help in the identification of prognostic and diagnostic biomarkers. PMID:26106326

  6. Intranuclear rods myopathy with autonomic dysfunction.

    PubMed

    Chou, Po-Ching; Liang, Wen-Chen; Nonaka, Ikuya; Mitsuhashi, Satomi; Nishino, Ichizo; Jong, Yuh-Jyh

    2013-08-01

    Intranuclear rods myopathy (IRM), a variant of nemaline myopathy (NM), is characterized by rod structure in the myonuclei. Patients with IRM present with similar symptoms to those of severe infantile-type NM but have worse outcome. Several extramuscular manifestations have been reported in NM but no dysautonomia. We herein report a 2-year-old girl with IRM and a heterozygous mutation, c.430C>T (p.L144F) in ACTA1. During the infancy, the patient showed severe diaphoresis and facial flushing. Arrhythmia and hypertension with the precipitating factors of feeding, defecation, and urination were observed. Sympathetic antagonist was prescribed and showed some effectiveness. Our report may widen the clinical spectrum of IRM. It also reminds clinicians that autonomic dysfunction may occur in patients with IRM or other actinopathies and appropriate treatment may be necessary. PMID:23102861

  7. Subclinical autonomic dysfunction in patients with ?-thalassemia.

    PubMed

    Stamboulis, Elefterios; Vlachou, Nikoleta; Voumvourakis, Konstantinos; Andrikopoulou, Athina; Arvaniti, Chrisa; Tsivgoulis, Athanasios; Athanasiadis, Dimitrios; Tsiodras, Sotirios; Tentolouris, Nikolaos; Triantafyllidi, Heleni; Drossou-Servou, Marouso; Loutradi-Anagnostou, Aphrodite; Tsivgoulis, Georgios

    2012-06-01

    We electrophysiologically evaluated the autonomic function (AF) in a consecutive series of patients with beta-thalassemia and in normal individuals. Six quantitative autonomic function tests (AFTs) were used: tilt test, hand grip test and sympathetic skin response for sympathetic function; R-R interval, inspiration-expiration difference and 30/15 ratio for parasympathetic function. The prevalence of impaired AF was higher in beta-thalassemia patients (13%, n = 5) than in control subjects (0%, n = 0; p = 0.026). Subclinical autonomic dysfunction appeared to be more prevalent in beta-thalassemia patients compared to controls in our series. Further independent validation of this finding is required in larger cohorts of beta-thalassemia patients. PMID:22170296

  8. Mechanisms of Neuromuscular Dysfunction in Critical Illness

    PubMed Central

    Khan, Jaffar; Harrison, Taylor B; Rich, Mark M.

    2008-01-01

    The development of neuromuscular dysfunction (NMD) during critical illness is increasingly recognized as a cause of failure to wean from mechanical ventilation and is associated with significant morbidity and mortality. At times it is difficult to identify the presence of NMD and distinguish the etiology of the weakness in patients with critical illness, but subtle clinical findings and bedside electrophysiological testing are helpful in establishing the diagnosis. The purpose of this review is to describe the clinical spectrum of acquired neuromuscular weakness in the setting of critical illness, provide an approach to diagnosis, and to discuss its pathogenesis. Finally, we propose defective sodium channel regulation as a unifying mechanism underlying NMD in critically ill patients. PMID:18241784

  9. Ciliary dysfunction in developmental abnormalities and diseases.

    PubMed

    Sharma, Neeraj; Berbari, Nicolas F; Yoder, Bradley K

    2008-01-01

    Cilia are small microtubule-based cellular appendages that are broadly classified as being either motile or immotile (primary cilia). Since their initial discovery several centuries ago, motile cilia have been of general interest to basic scientists and others who study the dynamics and physiological relevance of their motility. More recent discoveries have found that motile and immotile cilia, the later of which are present on nearly all cells in the mammalian body, also have major roles during development and in postnatal life. Dysfunction of the cilium is the basis for multiple human genetic disorders that have collectively been called the ciliopathies. The phenotypes associated with cilia dysfunction in mammals are diverse and include randomization of the left-right body axis, abnormalities in neural tube closure and patterning, skeletal defects such as polydactyly, cystic kidney, liver, and pancreatic diseases, blindness and anosmia, behavioral and cognitive defects, and obesity. The connection between disease and developmental defects due to the loss of ciliary function has brought the efforts of the biomedical research establishment to bear on this underappreciated and long overlooked organelle. Several groups have applied en silico, genetic, and biochemical approaches to identify the components of the cilia proteome. The resulting datasets have contributed to a remarkable increase in the rate at which human ciliopathy disease loci are being identified. This intense basic and clinical research interest has revealed that the cilium is a very complex sensory machine involved in transducing extracellular stimuli involved in many different signaling pathways into cellular responses. Although major advances have been made in understanding the importance of the cilium, it remains enigmatic how the cilium functions to coordinate signaling pathways and how loss of this organelle results in the severe defects observed in human ciliopathies. PMID:19147012

  10. Role of estrogen in diastolic dysfunction

    PubMed Central

    Zhao, Zhuo; Wang, Hao; Jessup, Jewell A.; Lindsey, Sarah H.; Chappell, Mark C.

    2014-01-01

    The prevalence of left ventricular diastolic dysfunction (LVDD) sharply increases in women after menopause and may lead to heart failure. While evidence suggests that estrogens protect the premenopausal heart from hypertension and ventricular remodeling, the specific mechanisms involved remain elusive. Moreover, whether there is a protective role of estrogens against cardiovascular disease, and specifically LVDD, continues to be controversial. Clinical and basic science have implicated activation of the renin-angiotensin-aldosterone system (RAAS), linked to the loss of ovarian estrogens, in the pathogenesis of postmenopausal diastolic dysfunction. As a consequence of increased tissue ANG II and low estrogen, a maladaptive nitric oxide synthase (NOS) system produces ROS that contribute to female sex-specific hypertensive heart disease. Recent insights from rodent models that mimic the cardiac phenotype of an estrogen-insufficient or -deficient woman (e.g., premature ovarian failure or postmenopausal), including the ovariectomized congenic mRen2.Lewis female rat, provide evidence showing that estrogen modulates the tissue RAAS and NOS system and related intracellular signaling pathways, in part via the membrane G protein-coupled receptor 30 (GPR30; also called G protein-coupled estrogen receptor 1). Complementing the cardiovascular research in this field, the echocardiographic correlates of LVDD as well as inherent limitations to its use in preclinical rodent studies will be briefly presented. Understanding the roles of estrogen and GPR30, their interactions with the local RAAS and NOS system, and the relationship of each of these to LVDD is necessary to identify new therapeutic targets and alternative treatments for diastolic heart failure that achieve the cardiovascular benefits of estrogen replacement without its side effects and contraindications. PMID:24414072

  11. Dysfunctional HCN ion channels in neurological diseases

    PubMed Central

    DiFrancesco, Jacopo C.; DiFrancesco, Dario

    2015-01-01

    Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are expressed as four different isoforms (HCN1-4) in the heart and in the central and peripheral nervous systems. HCN channels are activated by membrane hyperpolarization at voltages close to resting membrane potentials and carry the hyperpolarization-activated current, dubbed If (funny current) in heart and Ih in neurons. HCN channels contribute in several ways to neuronal activity and are responsible for many important cellular functions, including cellular excitability, generation, and modulation of rhythmic activity, dendritic integration, transmission of synaptic potentials, and plasticity phenomena. Because of their role, defective HCN channels are natural candidates in the search for potential causes of neurological disorders in humans. Several data, including growing evidence that some forms of epilepsy are associated with HCN mutations, support the notion of an involvement of dysfunctional HCN channels in different experimental models of the disease. Additionally, some anti-epileptic drugs are known to modify the activity of the Ih current. HCN channels are widely expressed in the peripheral nervous system and recent evidence has highlighted the importance of the HCN2 isoform in the transmission of pain. HCN channels are also present in the midbrain system, where they finely regulate the activity of dopaminergic neurons, and a potential role of these channels in the pathogenesis of Parkinson’s disease has recently emerged. The function of HCN channels is regulated by specific accessory proteins, which control the correct expression and modulation of the neuronal Ih current. Alteration of these proteins can severely interfere with the physiological channel function, potentially predisposing to pathological conditions. In this review we address the present knowledge of the association between HCN dysfunctions and neurological diseases, including clinical, genetic, and physiopathological aspects. PMID:25805968

  12. Sensory processing dysfunction among Saudi children with and without autism

    PubMed Central

    Al-Heizan, Mohammed O.; AlAbdulwahab, Sami S; Kachanathu, Shaji John; Natho, Mohan

    2015-01-01

    [Purpose] There is a dearth of studies that have examined the occurrence of sensory processing dysfunction and its components in Saudi Arabian children with autism. Therefore, this study investigated the manifestation of sensory processing dysfunction in autism and compared the functional components of sensory processing between Saudi Arabian children with and without autism. [Subjects and Methods] A convenience sample of 46 Saudi Arabian children with autism and 30 children without autism participated in this study. The sensory processing functions of both groups were assessed with the Short Sensory Profile. [Results] The overall findings indicated that 84.8% of children with autism demonstrated definite sensory processing dysfunction. The most prevalent sensory processing dysfunctions involved the under-responsive/seeks sensation (89.13%), auditory filtering (73.90%), and tactile sensitivity (60.87%) domains. Most of the children without autism (66.66%) demonstrated typical sensory function; the most prevalent sensory processing dysfunctions involved the tactile sensitivity (33.3%), under-responsive/seeks sensation (23.33%), and movement sensitivity (20%) domains. [Conclusion] Saudi Arabian children with and without autism have clinically significant sensory dysfunctions. However, the prevalence of those sensory dysfunctions in children with autism is significantly higher than in the children without autism.

  13. Sexual dysfunction in women with obstructive sleep apnea

    Microsoft Academic Search

    Shyam Subramanian; Swetha Bopparaju; Ashesh Desai; Tammy Wiggins; Cheryl Rambaud; Salim Surani

    2010-01-01

    Background  Female sexual dysfunction is vastly under-recognized but has been previously described in chronic disease states. Sexual dysfunction\\u000a in male patients with obstructive sleep apnea (OSA) is well described, but not in females.\\u000a \\u000a \\u000a \\u000a \\u000a Objective  The objective of this study was to assess the prevalence of sexual dysfunction in women with OSA.\\u000a \\u000a \\u000a \\u000a Methods  We studied 21 consecutive pre-menopausal women with OSA, referred to our

  14. MDR1 in paroxetine-induced sexual dysfunction.

    PubMed

    Zourková, Alexandra; Slana?, Ond?ej; Jarkovský, Ji?í; Pal?íková, Ivana; Pindurová, Eva; Cvanová, Michaela

    2013-01-01

    Paroxetine-induced sexual dysfunction represents a frequent treatment complication of otherwise efficient antidepressants. The genetic polymorphism of pharmacokinetic genes may contribute to the occurrence of such dysfunctions. This study presents the effect of MDR1 gene polymorphisms on sexual function in 18 women with bulimia nervosa, 18 women with anxiety disorders, and 19 healthy control subjects. It also deals with the relation between MDR1 gene polymorphisms and paroxetine-induced sexual dysfunction. The results demonstrated that MDR1 G2677T/A gene polymorphism allele carriers treated with paroxetine presented with difficulties with orgasm (p = .008) and lubrication (p < .001). PMID:23152970

  15. Monocyte implication in renal allograft dysfunction

    PubMed Central

    Guillén-Gómez, E; Guirado, L; Belmonte, X; Maderuelo, A; Santín, S; Juarez, C; Ars, E; Facundo, C; Ballarín, J A; Vidal, S; Díaz-Encarnación, M M

    2014-01-01

    Macrophages are involved in the development and progression of kidney fibrosis. The aim of this study was to analyse the phenotype of circulating monocytes and their ability to predict kidney allograft dysfunction in living kidney transplant recipients. Whole blood samples from 25 kidney recipients and 17 donors were collected at five time-points. Monocyte phenotype was analysed by flow cytometry, and interleukin (IL)-10 and soluble CD163 by enzyme-linked immunosorbent assay. One week after transplantation, surface CD163 and IL-10 levels increased significantly from baseline [2·99 ± 1·38 mean fluorescence intensity (MFI) to 5·18 ± 2·42 MFI for CD163; 4·5 ± 1·46 pg/ml to 6·7 ± 2·5 pg/ml for IL-10]. This CD163 increase correlated with 4-month creatinine levels (r = 0·4394, P = 0·04). However, soluble CD163 decreased significantly from baseline at 1 week (797·11 ± 340·45 ng/ml to 576·50 ± 293·60 ng/ml). CD14+CD16– monocytes increased at 4 months and correlated positively with creatinine levels at 12 and 24 months (r = 0·6348, P = 0·002 and r = 0·467, P = 0·028, respectively) and negatively with Modification of Diet in Renal Disease (MDRD) at 12 months (r = 0·6056, P = 0·003). At 4 months, IL-10 decreased significantly (P = 0·008) and correlated positively with creatinine at 2 years (r = 0·68, P = 0·010) and with CD14+CD16– monocytes at 4 months (r = 0·732, P = 0·004). At 24 h, levels of human leucocyte antigen D-related declined from 12·12 ± 5·99 to 5·21 ± 3·84 and CD86 expression decreased from 2·76 ± 1·08 to 1·87 ± 0·95. Both markers recovered progressively until 12 months, when they decreased again. These results indicate that monitoring monocytes could be a promising new prognostic tool of graft dysfunction in renal transplant patients. PMID:24134783

  16. Female Sexual Dysfunction: Prevalence and Risk Factors

    PubMed Central

    Jaafarpour, Molouk; Khani, Ali; Khajavikhan, Javaher; Suhrabi, Zeinab

    2013-01-01

    Background and Aim: Sexual dysfunction adversely affects quality of life, self esteem and interpersonal relationships and it may often be responsible for psychopathological disturbances. The purpose of this study was to explore the prevalence and associated risk factors for Female Sexual Dysfunction (FSD) in women with Kurdish culture from western Iran . Material and Methods: This was a cross-sectional descriptive survey which included 400 women aged 18–50 years old, married, from Ilam-IR, who were interviewed as per the Iranian version of Female Sexual Function Index (FSFI). The subjects were randomly selected from 4 primary health centres. Results: According to the findings, 185 (46.2%) women reported FSD. Prevalence of FSD increased with age, from 22% in women aged <20 years to 75.7% in women aged 40-50 years. FSD was detected as a desire problem in 45.3% of women, an arousal problem in 37.5%, a lubrication problem in 41.2%, an orgasm problem in 42.0%, a satisfaction problem in 44.5% and a pain problem in 42.5%. The educational level was inversely correlated with the risk of FSD (OR: 1.54 ,95% CI: 1.09-2.13). Patients with FSD were significantly more likely to be older than 40 years (OR: 2.23, 95% CI: 1.12-2.68), who had sexual intercourse fewer than 3 times a week (OR:1.85, 95% CI: 1.23-1.99), who had been married for 10 years or more (OR:1.76, 95% CI: 1.04-1.97), who had 3 children or more (OR: 1.48, 95% CI: 0.97-1.24), who had husbands aged 40 years or more (OR: 2.11, 95% CI: 1.35-2.37) and who were unemployed (OR: 1.34, 95% CI: 1.06-1.63). No significant differences were detected in smoking history, residences and contraception methods used (p>0.05). Conclusion: FSD needs to be recognized as a significant public health problem in Kurd women. Further research, particularly studies on awareness and competency of physicians in the management of FSD, is required. PMID:24551663

  17. [Statine and endothelium dysfunction in diabetes].

    PubMed

    Rosati, E; Aracri, N; Bottone, A; Cau, C; Scotti, E

    2002-02-01

    Diabetes is associated with significant morbidity and mortality in the setting of acute coronary syndromes. Exists a progressive relationship between glucose levels and cardiovascular risk. Hyperglycemy in fact produces endothelial dysfunction recognised to be a key accessory to diabetic microangiopathy and macroangiopathy. Furthermore diabetics present high levels of cholesterol which elevate the risk of CHD. The statins, for their effects, may represent the fit therapy. The beneficial effects of statins may extend beyond improving the lipid profile. There are several proposed mechanisms for event reduction by lipid-lowering therapy, which include improved endothelium-dependent vasodilation, stabilization of atherosclerotic lesions, reduction in inflammatory stimuli, and prevention, slowed progression, or regression of atherosclerotic lesions (pleiotropic effects). Cellular experiments suggest that statins have an impact on endothelial function by preventing oxidized LDL-induced reduction of nitric oxide production and increased nitric oxide synthesis. Statins also impact chronic inflammation by reducing mitogen (PDGF) responsiveness, inhibiting smooth muscle cell proliferation, inhibiting monocyte chemotaxis and migration, and by reducing macrophage protease production. The absolute clinical benefit achieved may be greater in diabetic than in nondiabetic patients with CHD because diabetic patients have a higher absolute risk of recurrent CHD events and other atherosclerotic events. PMID:11830720

  18. Cannabinoids: potential targets for bladder dysfunction.

    PubMed

    Ruggieri, Michael R

    2011-01-01

    Cannabinoids are the active chemical components of Cannabis sativa (marijuana). The medical use of cannabis goes back over 5,000 years. Cannabinoids produce a very wide array of central and peripheral effects, some of which may have beneficial clinical applications. The discovery of cannabinoid receptors has spawned great interest within the pharmaceutical industry with the hopes of capitalizing on the beneficial effects of cannabis without the unwanted psychotropic effects on the central and peripheral nervous system. This chapter presents an overview of the pharmacology of cannabinoids and their derivatives. It reviews the current literature on central and peripheral cannabinoid receptors as related to effects on the lower urinary tract and the role of these receptors in normal and abnormal urinary tract function. An objective evaluation of the published results of clinical trials of cannabis extracts for the treatment of bladder dysfunction resulting from multiple sclerosis is also presented. It is clear that cannabinoid receptors are present in the lower urinary tract as well as spinal and higher centers involved in lower urinary tract control. Systemic cannabinoids have effects on the lower urinary tract that may be able to become clinically useful; however, a much greater understanding of the mechanisms of cannabinoid receptors in control of the human lower urinary tract is necessary to facilitate development of novel cannabinoid drugs for treatment of pelvic disorders. PMID:21290238

  19. Asymmetric Dimethylarginine, Endothelial Dysfunction and Renal Disease

    PubMed Central

    Aldámiz-Echevarría, Luis; Andrade, Fernando

    2012-01-01

    l-Arginine (Arg) is oxidized to l-citrulline and nitric oxide (NO) by the action of endothelial nitric oxide synthase (NOS). In contrast, protein-incorporated Arg residues can be methylated with subsequent proteolysis giving rise to methylarginine compounds, such as asymmetric dimethylarginine (ADMA) that competes with Arg for binding to NOS. Most ADMA is degraded by dimethylarginine dimethyaminohydrolase (DDAH), distributed widely throughout the body and regulates ADMA levels and, therefore, NO synthesis. In recent years, several studies have suggested that increased ADMA levels are a marker of atherosclerotic change, and can be used to assess cardiovascular risk, consistent with ADMA being predominantly absorbed by endothelial cells. NO is an important messenger molecule involved in numerous biological processes, and its activity is essential to understand both pathogenic and therapeutic mechanisms in kidney disease and renal transplantation. NO production is reduced in renal patients because of their elevated ADMA levels with associated reduced DDAH activity. These factors contribute to endothelial dysfunction, oxidative stress and the progression of renal damage, but there are treatments that may effectively reduce ADMA levels in patients with kidney disease. Available data on ADMA levels in controls and renal patients, both in adults and children, also are summarized in this review. PMID:23109853

  20. MicroRNA Signature and Cardiovascular Dysfunction.

    PubMed

    Arunachalam, Gnanapragasam; Upadhyay, Rohit; Ding, Hong; Triggle, Chris R

    2015-05-01

    The worldwide increase in the prevalence of obesity and type 2 diabetes and the associated elevated risk of cardiovascular disease (CVD) has emphasized the need to seek new therapeutic targets to offset the negative impact on human health outcomes. In this regards, microRNAs (miRNAs), a class of small noncoding RNAs that mediate posttranscriptional gene silencing, have received considerable interest. miRNAs repress gene expression by their ability to pair with target sequences in the 3' untranslated region of the messenger RNA. miRNAs play a crucial role in the biogenesis and function of the cardiovascular system and are implicated as dynamic regulators of cardiac and vascular signaling and pathophysiology. Numerous miRNAs have been identified as novel biomarkers and potential therapeutic targets for CVD. In this review, we discuss the contribution of miRNAs to the regulation of CVD, their role in macrovascular/microvascular (dys)function, their potential as important biomarkers for the early detection of CVD, and, finally, as therapeutic targets. PMID:25384197

  1. Group vs. couple treatment of sexual dysfunctions.

    PubMed

    Golden, J S; Price, S; Heinrich, A G; Lobitz, W C

    1978-11-01

    Results of a study comparing the effectiveness of two formats for treating men with premature ejaculation and their female partners with orgasmic dysfunctions are described. In one treatment format, a couple was treated by a male and female cotherapy team once a week for 12 sessions. In the second treatment format, which also consisted of 12 weekly sessions, three or four couples were treated simultaneously in a group led by a cotherapy team. The five couples treated alone and the ten couples treated in the group format all received a standardized therapy program consisting of sex education, attitude restructuring, and specific suggestions for acquiring ejaculatory control for the men and an increased range of orgasmic response for the females. The results showed significant improvement for couples in both treatment formats. The group format initially showed a slight tendency toward more rapid progress than did the couple format, but by the 2-month follow-up there were no significant differences. The study demonstrates that couple group treatment is a cost-effective means for treating common male and female sexual problems. PMID:742968

  2. Pharmacogenetics of SSRIs and Sexual Dysfunction

    PubMed Central

    Osis, Liana; Bishop, Jeffrey R.

    2010-01-01

    Sexual dysfunction (SD) is a common and disconcerting side effect of selective serotonin reuptake inhibitors (SSRIs) that often influences a patient’s desire to continue long-term antidepressant treatment. Studies specifically assessing changes in sexual well-being over time illustrate that the incidence of sexual side effects from SSRIs ranges from 20% to 70%, depending on the characteristics of the study sample assessed. Developing strategies to predict who may be at the highest risk for adverse changes in their sexual well-being is an important step in improving the quality of life and treatment of patients who require antidepressant therapy. Pharmacogenetic studies of SSRI-associated SD have identified associations between serotonin and glutamate system genes with aspects of SD. The results of studies investigating genetic variations in drug metabolism enzymes and their relationships to antidepressant-associated adverse effects have been mixed. Continued efforts to characterize the relationships between genetic markers and antidepressant outcomes, and to translate this knowledge to patient care, have the potential to significantly improve the empiric selection of antidepressant agents and to minimize the risk for intolerable side effects.

  3. Women's sexual dysfunction: revised and expanded definitions

    PubMed Central

    Basson, Rosemary

    2005-01-01

    ACCEPTANCE OF AN EVIDENCE-BASED CONCEPTUALIZATION OF WOMEN'S SEXUAL RESPONSE combining interpersonal, contextual, personal psychological and biological factors has led to recently published recommendations for revision of definitions of women's sexual disorders found in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM–IV-TR). DSM-IV definitions have focused on absence of sexual fantasies and sexual desire prior to sexual activity and arousal, even though the frequency of this type of desire is known to vary greatly among women without sexual complaints. DSM-IV definitions also focus on genital swelling and lubrication, entities known to correlate poorly with subjective sexual arousal and pleasure. The revised definitions consider the many reasons women agree to or instigate sexual activity, and reflect the importance of subjective sexual arousal. The underlying conceptualization of a circular sex-response cycle of overlapping phases in a variable order may facilitate not only the assessment but also the management of dysfunction, the principles of which are briefly recounted. PMID:15883409

  4. TRP channels in lower urinary tract dysfunction

    PubMed Central

    Franken, J; Uvin, P; De Ridder, D; Voets, T

    2014-01-01

    Lower urinary tract dysfunction (LUTd) represents a major healthcare problem. Although it is mostly not lethal, associated social disturbance, medical costs, loss of productivity and especially diminished quality of life should not be underestimated. Although more than 15% of people suffer from a form of LUTd to some extent, pathophysiology often remains obscure. In the past 20 years, transient receptor potential (TRP) channels have become increasingly important in this field of research. These intriguing ion channels are believed to be the main molecular sensors that generate bladder sensation. Therefore, they are intensely pursued as new drug targets for both curative and symptomatic treatment of different forms of LUTd. TRPV1 was the first of its class to be investigated. Actually, even before this channel was cloned, it had already been targeted in the bladder, with clinical trials of intravesical capsaicin instillations. Several other polymodally gated TRP channels, particularly TRPM8, TRPA1 and TRPV4, also appear to play a prominent role in bladder (patho)physiology. With this review, we provide a brief overview of current knowledge on the role of these TRP channels in LUTd and their potential as molecular targets for treatment. Linked Articles This article is part of a themed section on the pharmacology of TRP channels. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-10 PMID:24895732

  5. Estrogens and Male Lower Urinary Tract Dysfunction.

    PubMed

    Wynder, Jalissa L; Nicholson, Tristan M; DeFranco, Donald B; Ricke, William A

    2015-09-01

    Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) are common clinical problems in urology and affect the majority of men at some time during their lives. The development of BPH/LUTS is associated with an increased ratio of estrogen to androgen levels, and this ratio, when mimicked in a variety of animals, induces BPH and lower urinary tract dysfunction (LUTD). While the precise molecular etiology remains unclear, estrogens have been implicated in the development and maintenance of BPH. Numerous endogenous and exogenous estrogens exist in humans. These estrogens act via multiple estrogen receptors to promote or inhibit prostatic hyperplasia and other BPH-associated processes. The prostate is an estrogen target tissue, and estrogens directly and indirectly affect growth and differentiation of prostate. The precise role of estrogen action directly affecting prostate growth and differentiation in the context of BPH is an understudied area and remains to be elucidated. Estrogens and selective estrogen receptor modulators (SERMs) have been shown to promote or inhibit prostate proliferation illustrating their potential roles in the development of BPH as therapy. More work will be required to identify estrogen signaling pathways associated with LUTD in order to develop more efficacious drugs for BPH treatment and prevention. PMID:26156791

  6. Mechanism of neuromuscular dysfunction in Krabbe disease.

    PubMed

    Cantuti-Castelvetri, Ludovico; Maravilla, Erick; Marshall, Michael; Tamayo, Tammy; D'auria, Ludovic; Monge, John; Jeffries, James; Sural-Fehr, Tuba; Lopez-Rosas, Aurora; Li, Guannan; Garcia, Kelly; van Breemen, Richard; Vite, Charles; Garcia, Jesus; Bongarzone, Ernesto R

    2015-01-28

    The atrophy of skeletal muscles in patients with Krabbe disease is a major debilitating manifestation that worsens their quality of life and limits the clinical efficacy of current therapies. The pathogenic mechanism triggering muscle wasting is unknown. This study examined structural, functional, and metabolic changes conducive to muscle degeneration in Krabbe disease using the murine (twitcher mouse) and canine [globoid cell leukodystrophy (GLD) dog] models. Muscle degeneration, denervation, neuromuscular [neuromuscular junction (NMJ)] abnormalities, and axonal death were investigated using the reporter transgenic twitcher-Thy1.1-yellow fluorescent protein mouse. We found that mutant muscles had significant numbers of smaller-sized muscle fibers, without signs of regeneration. Muscle growth was slow and weak in twitcher mice, with decreased maximum force. The NMJ had significant levels of activated caspase-3 but limited denervation. Mutant NMJ showed reduced surface areas and lower volumes of presynaptic terminals, with depressed nerve control, increased miniature endplate potential (MEPP) amplitude, decreased MEPP frequency, and increased rise and decay rate constants. Twitcher and GLD dog muscles had significant capacity to store psychosine, the neurotoxin that accumulates in Krabbe disease. Mechanistically, muscle defects involved the inactivation of the Akt pathway and activation of the proteasome pathway. Our work indicates that muscular dysfunction in Krabbe disease is compounded by a pathogenic mechanism involving at least the failure of NMJ function, activation of proteosome degradation, and a reduction of the Akt pathway. Akt, which is key for muscle function, may constitute a novel target to complement in therapies for Krabbe disease. PMID:25632136

  7. Exercise, intestinal barrier dysfunction and probiotic supplementation.

    PubMed

    Lamprecht, Manfred; Frauwallner, Anita

    2012-01-01

    Athletes exposed to high-intensity exercise show an increased occurrence of gastrointestinal (GI) symptoms like cramps, diarrhea, bloating, nausea, and bleeding. These problems have been associated with alterations in intestinal permeability and decreased gut barrier function. The increased GI permeability, a so-called 'leaky gut', also leads to endotoxemia, and results in increased susceptibility to infectious and autoimmune diseases, due to absorption of pathogens/toxins into tissue and the bloodstream. Key components that determine intestinal barrier function and GI permeability are tight junctions, protein structures located in the paracellular channels between epithelial cells of the intestinal wall. The integrity of tight junctions depends on sophisticated interactions between the gut residents and their expressed substances, the intestinal epithelial cell metabolism and the activities of the gut-associated lymphoid tissue. Probiotic supplements are an upcoming group of nutraceuticals that could offer positive effects on athlete's gut and entire health. Some results demonstrate promising benefits for probiotic use on the athlete's immune system. There is also evidence that probiotic supplementation can beneficially influence intestinal barrier integrity in acute diseases. With regard to exercise-induced GI permeability problems, there is still a lack of studies with appropriate data and a gap to understand the underlying mechanisms to support such health beneficial statements implicitly. This article refers (i) to exercise-induced intestinal barrier dysfunction, (ii) provides suggestions to estimate increased gut barrier permeability in athletes, and (iii) discusses the potential of probiotic supplementation to counteract an exercise-induced leaky gut. PMID:23075554

  8. Neuroendocrine dysfunction in polycystic ovary syndrome

    PubMed Central

    Burt Solorzano, Christine M.; Beller, Jennifer P.; Abshire, Michelle Y.; Collins, Jessicah S.; McCartney, Christopher R.; Marshall, John C.

    2012-01-01

    Polycystic ovarian syndrome (PCOS) is a common disorder characterized by ovulatory dysfunction and hyperandrogenemia (HA). Neuroendocrine abnormalities including increased gonadotropin-releasing hormone (GnRH) pulse frequency, increased luteinizing hormone (LH) pulsatility, and relatively decreased follicle stimulating hormone contribute to its pathogenesis. HA reduces inhibition of GnRH pulse frequency by progesterone, causing rapid LH pulse secretion and increasing ovarian androgen production. The origins of persistently rapid GnRH secretion are unknown but appear to evolve during puberty. Obese girls are at risk for HA and develop increased LH pulse frequency with elevated mean LH by late puberty. However, even early pubertal girls with HA have increased LH pulsatility and enhanced daytime LH pulse secretion, indicating the abnormalities may begin early in puberty. Decreasing sensitivity to progesterone may regulate normal maturation of LH secretion, potentially related to normally increasing levels of testosterone during puberty. This change in sensitivity may become exaggerated in girls with HA. Many girls with HA—especially those with hyperinsulinemia—do not exhibit normal LH pulse sensitivity to progesterone inhibition. Thus, HA may adversely affect LH pulse regulation during pubertal maturation leading to persistent HA and the development of PCOS. PMID:22172593

  9. Development of quantitative tools for assessment of cerebellar dysfunction

    E-print Network

    Garg, Aditi

    2005-01-01

    Two tools for the quantitative assessment of cerebellar dysfunction are developed and explored. One is based on a battery of laptop tests desgined for clinical use. Extensive analysis of one of the tests using a speed/accuracy ...

  10. Endothelial Dysfunction, Inflammation, and Apoptosis in Diabetes Mellitus

    PubMed Central

    van den Oever, Inge A. M.; Raterman, Hennie G.; Nurmohamed, Mike T.; Simsek, Suat

    2010-01-01

    Endothelial dysfunction is regarded as an important factor in the pathogenesis of vascular disease in obesity-related type 2 diabetes. The imbalance in repair and injury (hyperglycemia, hypertension, dyslipidemia) results in microvascular changes, including apoptosis of microvascular cells, ultimately leading to diabetes related complications. This review summarizes the mechanisms by which the interplay between endothelial dysfunction, inflammation, and apoptosis may cause (micro)vascular damage in patients with diabetes mellitus. PMID:20634940

  11. Treatment of postoperative voiding dysfunction following incontinence surgery

    Microsoft Academic Search

    Danielle D. Sweeney; Wendy W. Leng

    2007-01-01

    Persistent postoperative voiding dysfunction is a known complication following female stress incontinence surgery. Although\\u000a many variations on surgical technique exist, the most common cause remains attributable to hypersuspension of the urethra.\\u000a The diagnosis of postoperative voiding dysfunction in this setting can be challenging due to the lack of standardized criteria\\u000a and varied clinical presentation. Furthermore, patients can present with a

  12. Primary bladder neck dysfunction: An overlooked entity in children

    Microsoft Academic Search

    Neil H. Grafstein; Andrew J. Combs; Kenneth I. Glassberg

    2005-01-01

    Primary bladder neck dysfunction is a non-neurogenic voiding disorder commonly diagnosed in young and middle age adult men,\\u000a but frequently overlooked in children. Because these children typically present with lower urinary tract symptoms that also\\u000a are associated with other more common forms of dysfunctional voiding, the diagnosis may be missed and treated with a variety\\u000a of empiric modalities that ultimately

  13. Treatment of postoperative voiding dysfunction following incontinence surgery

    Microsoft Academic Search

    Danielle D. Sweeney; Wendy W. Leng

    2005-01-01

    Persistent postoperative voiding dysfunction is a known complication following female stress incontinence surgery. Although\\u000a many variations on surgical technique exist, the most common cause remains attributable to hypersuspension of the urethra.\\u000a The diagnosis of postoperative voiding dysfunction in this setting can be challenging due to the lack of standardized criteria\\u000a and varied clinical presentation. Furthermore, patients can present with a

  14. Antioxidant dysfunction: potential risk for neurotoxicity in ethylmalonic aciduria

    Microsoft Academic Search

    Christina B. Pedersen; Zarazuela Zolkipli; Søren Vang; Johan Palmfeldt; Margrethe Kjeldsen; Vibeke Stenbroen; Stinne P. Schmidt; Ronald J. A. Wanders; Jos P. N. Ruiter; Flemming Wibrand; Ingrid Tein; Niels Gregersen

    2010-01-01

    Mitochondrial dysfunction and oxidative stress are central to the molecular basis of several human diseases associated with\\u000a neuromuscular disabilities. We hypothesize that mitochondrial dysfunction also contributes to the neuromuscular symptoms observed\\u000a in patients with ethylmalonic aciduria and homozygosity for ACADS c.625G>A-a common variant of the short-chain acyl-coenzyme A (CoA) dehydrogenase (SCAD) enzyme in the mitochondrial fatty\\u000a acid oxidation pathway. This

  15. Management of erectile dysfunction in diabetes: An update for 2008

    Microsoft Academic Search

    David Price; Geoffrey Hackett

    2008-01-01

    Tumescence occurs as a result of nitric oxide (NO)-mediated smooth muscle relaxation of the erectile tissue leading to engorgement\\u000a of the corpus cavernosum. The process is initiated by neuronal NO release and maintained by NO released by the local vascular\\u000a endothelium. Erectile dysfunction (ED) affects 30% to 40% of diabetic men and occurs as a result of endothelial dysfunction\\u000a and

  16. Renal dysfunction in acute heart failure: epidemiology, mechanisms and assessment

    Microsoft Academic Search

    Valentina Carubelli; Marco Metra; Carlo Lombardi; Luca Bettari; Silvia Bugatti; Valentina Lazzarini; Livio Dei Cas

    Renal dysfunction is often present and\\/or worsens in patients with heart failure and this is associated with increased costs\\u000a of care, complications and mortality. The cardiorenal syndrome can be defined as the presence or development of renal dysfunction\\u000a in patients with heart failure. Its mechanisms are likely related to low cardiac output, increased venous congestion and renal\\u000a venous pressure, neurohormonal

  17. Prevalence of Musculoskeletal Dysfunctions among Indian Pregnant Women

    PubMed Central

    Maiya, Arun G.; Kumar, Pratap; Kamath, Asha

    2015-01-01

    Background and Objectives. Pregnancy triggers a wide range of changes in a woman's body leading to various musculoskeletal dysfunctions. Most commonly reported musculoskeletal discomforts by pregnant women are low back pain and symphysis pubis pain. The culture and the environmental factors may influence the discomforts experienced by a pregnant woman. There is a dearth of literature in India, regarding the common musculoskeletal dysfunctions experienced by a pregnant woman, and hence this study. Method. A questionnaire to identify the musculoskeletal dysfunction was developed; content was validated and was translated to local languages through parallel back translation. 261 primiparous pregnant women participated in the study and filled the questionnaire in their native language. Results. Among the musculoskeletal dysfunctions reported by the pregnant women, 64.6% reported calf muscle cramps, 37.1% reported foot pain, and 33.7% experienced low back pain in their third trimester. In the second trimester, common musculoskeletal dysfunctions experienced by the women were that of calf pain (47.8%), low back pain (42%), and pelvic girdle pain (37%). Conclusion. Musculoskeletal dysfunctions and general discomforts very commonly affect the activities of daily living of pregnant women. Understanding the common discomforts during various trimesters of pregnancy will help to develop a comprehensive program for prevention and cure. PMID:25642349

  18. Male sexual dysfunction and HIV--a clinical perspective.

    PubMed

    Santi, Daniele; Brigante, Giulia; Zona, Stefano; Guaraldi, Giovanni; Rochira, Vincenzo

    2014-02-01

    Sexual dysfunction in men with HIV is often overlooked by clinicians owing to many factors, including the taboo of sexuality. The improved life expectancy of patients with HIV requires physicians to consider their general wellbeing and sexual health with a renewed interest. However, data on sexual dysfunction in those with HIV are scarce. Erectile dysfunction (ED) is the most common sexual dysfunction in men, with a prevalence of ?30-50% and is frequent even in men <40 years of age. HIV infection itself is the strongest predictor of ED, and many factors related to the infection-fear of virus transmission, changes in body image, HIV-related comorbidities, infection stigma, obligatory condom use-all impair erectile function. The diagnosis and treatment of sexual dysfunction is based on a multidisciplinary approach, which involves specialists in both infectious diseases and sexual medicine. Particular attention should be paid to the promotion of safer sex in these patients. This Review, describes the issues surrounding sexual dysfunction in men with HIV and aims to provide clinical advice for the physician treating these patients. PMID:24394405

  19. Redox-sensitive mechanisms underlying vascular dysfunction in heart failure.

    PubMed

    Konradi, J; Mollenhauer, M; Baldus, S; Klinke, A

    2015-06-01

    Regardless of the progress in therapeutic drugs and devices to treat heart failure (HF) during the last few years, the clinical outcome of this disease remains deleterious. Impaired left ventricular function leads to neurohumoral activation, altered local shear forces, and hypoxia, which might give rise to inflammatory processes within the vasculature. Among those, the imbalance of the redox equilibrium toward increased concentrations of reactive oxygen species (ROS) is particularly important, as it affects the integrity of vascular function. Apart from injured or dysfunctional cardiomyocytes, vascular dysfunction has been demonstrated to play a crucial role in the development and progression of HF, which makes it an interesting target for new HF therapies. The mechanisms that initiate vascular dysfunction in HF pathogenesis and the processes leading to oxidative stress are not yet fully elucidated. However, oxidative stress promotes a variety of redox-sensitive mechanisms contributing to vascular dysfunction in HF. Here, we will summarize the sources of ROS in the vasculature, elucidate the impact of oxidative stress on functional and structural vascular remodeling, and consider the link to vascular dysfunction. Furthermore, we will point out the importance of vascular dysfunction in HF and discuss therapeutic options. PMID:25788126

  20. Udenafil for the treatment of erectile dysfunction

    PubMed Central

    Cho, Min Chul; Paick, Jae-Seung

    2014-01-01

    Erectile dysfunction (ED) is often perceived by both patients and sexual partners as a serious problem that can jeopardize quality of life, psychosocial or emotional well-being, and the partnership in the long term. Since their introduction, oral phosphodiesterase type 5 inhibitors (PDE5Is) have been found to be highly effective and well tolerated, and are available as the first-line therapy for the treatment of ED. Udenafil is one of the selective PDE5Is made available in recent years for the treatment of ED. Udenafil has clinical properties of both relatively rapid onset and long duration of action due to its pharmacokinetic profile, thereby providing an additional treatment option for ED men to better suit individual needs. There is positive evidence that udenafil is effective and well tolerated in the treatment of ED of a broad spectrum of etiologies or severity. Udenafil is as effective in the treatment of diabetes mellitus-associated ED as other PDE5Is. Due to the clinical property of relatively long duration of action, udenafil may be another option in daily dosing treatment for ED, as suggested by its favorable efficacy and safety profile. Most adverse effects reported from clinical trials are mild or moderate in severity, without any serious adverse event, with headache and flushing being the most common. Also, the concomitant use of anti-hypertensive drugs or alpha-1-blockers does not significantly affect the efficacy and safety profile of udenafil. However, additional studies with larger cohorts including prospective, multicenter, comparative studies with patients of different ethnicities are needed to further validate the favorable findings of udenafil in the treatment of ED. PMID:24868160

  1. Rosuvastatin improves endothelial dysfunction in ankylosing spondylitis.

    PubMed

    Garg, Nidhi; Krishan, Pawan; Syngle, Ashit

    2015-06-01

    Enhanced cardiovascular risk in ankylosing spondylitis (AS) provides a strong rationale for early therapeutical intervention. In view of the proven benefit of statins in atherosclerotic vascular disease, we aimed to investigate the effect of rosuvastatin on endothelial dysfunction (ED) and inflammatory disease activity in AS. In a single-blind, placebo-controlled, parallel study, 32 AS patients were randomized to receive 24 weeks of treatment with rosuvastatin (10 mg/day, n?=?17) and placebo (n?=?15) as an adjunct to existing stable antirheumatic drugs. Flow-mediated dilatation (FMD) was assessed by AngioDefender™ (Everest Genomic Ann Arbor, USA). Inflammatory measures (BASDAI, BASFI, CRP and ESR) and pro-inflammatory cytokines (tumour necrosis factor-alpha [TNF-?], interleukin-6 [IL-6] and interleukin-1 [IL-1]) were measured at baseline and after treatment. Lipids and adhesion molecules (intracellular adhesion molecule [ICAM-1] and vascular cell adhesion molecule [VCAM-1]) were estimated at baseline and after treatment. At baseline, inflammatory measures, pro inflammatory cytokines and adhesion molecules were elevated among both groups. After treatment with rosuvastatin, FMD improved significantly (p?

  2. Female sexual dysfunction: focus on low desire.

    PubMed

    Kingsberg, Sheryl A; Woodard, Terri

    2015-02-01

    Low or absent sexual desire is the most common sexual dysfunction in women, and its prevalence peaks during midlife. Its etiology is complex and may include biologic, psychologic, and social elements. Major risk factors for its development include poor health status, depression, certain medications, dissatisfaction with partner relationship, and history of physical abuse, sexual abuse, or both. Diagnosis is based on criteria set by the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) and requires that a woman experience personal distress. Clinical evaluation should include medical history, sexual history, and, sometimes, a physical examination. Laboratory data are of limited value, except when warranted by history or physical examination. Treatment options include nonpharmacologic interventions such as education, office-based counseling, and psychotherapy. Although there are no U.S. Food and Drug Administration (FDA)-approved treatments for low desire, pharmacologic agents have been used off-label for this purpose. Bupropion is an antidepressant that has been shown to improve desire in some women with and without depression. Systemic estrogen therapy is not recommended in the absence of vasomotor symptoms and is not directly associated with desire. However, vaginal estrogen is useful in patients presenting with concomitant vaginal atrophy and dyspareunia. Ospemifene is a selective estrogen receptor modulator that can be used as an alternative to vaginal estrogen. Exogenous testosterone has demonstrated efficacy in treating loss of desire in postmenopausal women. However, patients should be counseled that it is not FDA-approved for this purpose and there are limited published long-term safety data. Several agents for the treatment of low desire are currently in development. Gynecologists are in a unique position to address concerns about sexual desire in women. PMID:25569014

  3. Scents and Nonsense: Olfactory Dysfunction in Schizophrenia

    PubMed Central

    Turetsky, Bruce I.; Hahn, Chang-Gyu; Borgmann-Winter, Karin; Moberg, Paul J.

    2009-01-01

    Among the sensory modalities, olfaction is most closely associated with the frontal and temporal brain regions that are implicated in schizophrenia and most intimately related to the affective and mnemonic functions that these regions subserve. Olfactory probes may therefore be ideal tools through which to assess the structural and functional integrity of the neural substrates that underlie disease-related cognitive and emotional disturbances. Perhaps more importantly, to the extent that early sensory afferents are also disrupted in schizophrenia, the olfactory system—owing to its strategic anatomic location—may be especially vulnerable to such disruption. Olfactory dysfunction may therefore be a sensitive indicator of schizophrenia pathology and may even serve as an “early warning” sign of disease vulnerability or onset. In this article, we review the evidence supporting a primary olfactory sensory disturbance in schizophrenia. Convergent data indicate that structural and functional abnormalities extend from the cortex to the most peripheral elements of the olfactory system. These reflect, in part, a genetically mediated neurodevelopmental etiology. Gross structural and functional anomalies are mirrored by cellular and molecular abnormalities that suggest decreased or faulty innervation and/or dysregulation of intracellular signaling. A unifying mechanistic hypothesis may be the epigenetic regulation of gene expression. With the opportunity to obtain olfactory neural tissue from live patients through nasal epithelial biopsy, the peripheral olfactory system offers a uniquely accessible window through which the pathophysiological antecedents and sequelae of schizophrenia may be observed. This could help to clarify underlying brain mechanisms and facilitate identification of clinically relevant biomarkers. PMID:19793796

  4. Mitochondrial Dysfunction in Lyssavirus-Induced Apoptosis? †

    PubMed Central

    Gholami, Alireza; Kassis, Raïd; Real, Eléonore; Delmas, Olivier; Guadagnini, Stéphanie; Larrous, Florence; Obach, Dorothée; Prevost, Marie-Christine; Jacob, Yves; Bourhy, Hervé

    2008-01-01

    Lyssaviruses are highly neurotropic viruses associated with neuronal apoptosis. Previous observations have indicated that the matrix proteins (M) of some lyssaviruses induce strong neuronal apoptosis. However, the molecular mechanism(s) involved in this phenomenon is still unknown. We show that for Mokola virus (MOK), a lyssavirus of low pathogenicity, the M (M-MOK) targets mitochondria, disrupts the mitochondrial morphology, and induces apoptosis. Our analysis of truncated M-MOK mutants suggests that the information required for efficient mitochondrial targeting and dysfunction, as well as caspase-9 activation and apoptosis, is held between residues 46 and 110 of M-MOK. We used a yeast two-hybrid approach, a coimmunoprecipitation assay, and confocal microscopy to demonstrate that M-MOK physically associates with the subunit I of the cytochrome c (cyt-c) oxidase (CcO) of the mitochondrial respiratory chain; this is in contrast to the M of the highly pathogenic Thailand lyssavirus (M-THA). M-MOK expression induces a significant decrease in CcO activity, which is not the case with M-THA. M-MOK mutations (K77R and N81E) resulting in a similar sequence to M-THA at positions 77 and 81 annul cyt-c release and apoptosis and restore CcO activity. As expected, the reverse mutations, R77K and E81N, introduced in M-THA induce a phenotype similar to that due to M-MOK. These features indicate a novel mechanism for energy depletion during lyssavirus-induced apoptosis. PMID:18321977

  5. Dysfunctional dopaminergic neurotransmission in asocial BTBR mice

    PubMed Central

    Squillace, M; Dodero, L; Federici, M; Migliarini, S; Errico, F; Napolitano, F; Krashia, P; Di Maio, A; Galbusera, A; Bifone, A; Scattoni, M L; Pasqualetti, M; Mercuri, N B; Usiello, A; Gozzi, A

    2014-01-01

    Autism spectrum disorders (ASD) are neurodevelopmental conditions characterized by pronounced social and communication deficits and stereotyped behaviours. Recent psychosocial and neuroimaging studies have highlighted reward-processing deficits and reduced dopamine (DA) mesolimbic circuit reactivity in ASD patients. However, the neurobiological and molecular determinants of these deficits remain undetermined. Mouse models recapitulating ASD-like phenotypes could help generate hypotheses about the origin and neurophysiological underpinnings of clinically relevant traits. Here we used functional magnetic resonance imaging (fMRI), behavioural and molecular readouts to probe dopamine neurotransmission responsivity in BTBR T+ Itpr3tf/J mice (BTBR), an inbred mouse line widely used to model ASD-like symptoms owing to its robust social and communication deficits, and high level of repetitive stereotyped behaviours. C57BL/6J (B6) mice were used as normosocial reference comparators. DA reuptake inhibition with GBR 12909 produced significant striatal DA release in both strains, but failed to elicit fMRI activation in widespread forebrain areas of BTBR mice, including mesolimbic reward and striatal terminals. In addition, BTBR mice exhibited no appreciable motor responses to GBR 12909. DA D1 receptor-dependent behavioural and signalling responses were found to be unaltered in BTBR mice, whereas dramatic reductions in pre- and postsynaptic DA D2 and adenosine A2A receptor function was observed in these animals. Overall these results document profoundly compromised DA D2-mediated neurotransmission in BTBR mice, a finding that is likely to have a role in the distinctive social and behavioural deficits exhibited by these mice. Our results call for a deeper investigation of the role of dopaminergic dysfunction in mouse lines exhibiting ASD-like phenotypes, and possibly in ASD patient populations. PMID:25136890

  6. Beneficial effect of the 5-HT1A receptor agonist buspirone on esophageal dysfunction associated with systemic sclerosis: A pilot study

    PubMed Central

    Panopoulos, Stylianos; Karlaftis, Anastasios; Denaxas, Konstantinos; Kamberoglou, Dimitrios; Sfikakis, Petros P; Ladas, Spiros D

    2015-01-01

    Background Esophageal involvement in systemic sclerosis (SSc) carries significant morbidity and is empirically managed with domperidone, albeit with questionable efficacy. The oral 5-HT1A receptor agonist buspirone may enhance esophageal peristalsis and lower esophageal sphincter (LES) function in healthy volunteers. Aim We aimed to test the hypothesis that buspirone may exert a beneficial acute effect on esophageal motor dysfunction in symptomatic patients with SSc. Methods Twenty consecutive patients with SSc reporting esophageal symptoms underwent high-resolution manometry before and 30?minutes after administration of buspirone (10?mg). Ten other patients received domperidone (10?mg) and served as control group. Changes in LES resting and residual pressure, amplitude, duration, and velocity of distal esophageal body contractions were examined. Results Esophageal hypomotility and hypotensive LES was found in 63% and 67% of patients, respectively. Demographic and clinical characteristics, including baseline manometric parameters, were comparable between groups. Resting pressure of LES increased after buspirone from 9.42?±?2.6 to 11.53?±?3.4?mmHg (p?=?0.0002 by paired t-test), but not after domperidone; a trend for increase of amplitude of contractions was also observed after buspirone (p?=?0.09). Comparison of the individual changes revealed that buspirone was superior to domperidone in enhancing LES pressure (?+?2.11?±?2.0 versus –0.45?±?2.3?mmHg, p?=?0.006). No significant effects of either drug were noted on other examined parameters of esophageal function. Conclusion The beneficial acute effect of buspirone on impaired LES function associated with SSc suggests a role of 5-HT1A receptor-mediated interactions in these patients. Prospective studies to examine whether buspirone is of long-term therapeutic value for SSc-associated esophageal disease are warranted. PMID:26137301

  7. Neurologic Factors in Female Sexual Function and Dysfunction

    PubMed Central

    Siroky, Mike B.

    2010-01-01

    Sexual dysfunction affects both men and women, involving organic disorders, psychological problems, or both. Overall, the state of our knowledge is less advanced regarding female sexual physiology in comparison with male sexual function. Female sexual dysfunction has received little clinical and basic research attention and remains a largely untapped field in medicine. The epidemiology of female sexual dysfunction is poorly understood because relatively few studies have been done in community settings. In the United States, female sexual dysfunction has been estimated to affect 40% of women in the general population. Among the elderly, however, it has been reported that up to 87% of women complain of sexual dissatisfaction. Several studies have shown that the prevalence of female sexual arousal disorders correlates significantly with increasing age. These studies have shown that sexual arousal and frequency of coitus in the female decreases with increasing age. The pathophysiology of female sexual dysfunction appears more complex than that of males, involving multidimensional hormonal, neurological, vascular, psychological, and interpersonal aspects. Organic female sexual disorders may include a wide variety of vascular, neural, or neurovascular factors that lead to problems with libido, lubrication, and orgasm. However, the precise etiology and mechanistic pathways of age-related female sexual arousal disorders are yet to be determined. In the past two decades, some advances have been made in exploring the basic hemodynamics and neuroregulation of female sexual function and dysfunction in both animal models and in human studies. In this review, we summarize neural regulation of sexual function and neurological causes of sexual dysfunction in women. PMID:20664775

  8. Environmental chemical-induced macrophage dysfunction.

    PubMed Central

    Loose, L D; Silkworth, J B; Charbonneau, T; Blumenstock, F

    1981-01-01

    Immunomodulation by environmental chemical contaminants and the role immune parameters play in toxicity and risk assessment studies is of increasing concern. Although considerable evidence has indicated that various xenobiotics may be immunosuppressive, little attention has been directed toward ascertaining a specific cellular locus which could be responsible for the impaired immune responsiveness. Since previous studies had suggested a macrophage defect in xenobiotic-induced immunosuppression and since macrophages are integral components of an immune response, an in-depth evaluation of macrophage function was conducted in xenobiotic-exposed mice. Macrophages isolated from mice receiving PCB, HCB, and dieldrin had no alteration in their in vitro O2 consumption while at rest or during phagocytosis. In addition, no alteration in in vitro phagocytic activity, phagocytic capacity or microbicidal activity was demonstrated. However, a significant impairment in the in vivo phagocytic clearance of a labelled antigen and an altered tissue distribution of the antigen was observed and was, perhaps, related, in part, to a significant decrease in serum fibronectin, an opsonic alpha 2 surface-binding glycoprotein. Furthermore, animals exposed to HCB and dieldrin, but not to PCB, had a profound decrease in their resistance to a challenge tumor cell implant which was related to a select alteration in tumor cell killing. The adherent spleen cells from HCB-treated mice had a profound suppression in their tumoricidal activity which was in contrast to dieldrin-treated mice, where the target cell type appeared to be the nonadherent cells. However, although dieldrin-exposed adherent cells (macrophages ?) did nt appear to have an altered tumoricidal capacity, all four macrophage types isolated from dieldrin-treated mice had a significantly impaired ability to process a cellular antigen. Splenic and alveolar macrophages appeared to be the most sensitive cell types to dieldrin. The present studies suggest that macrophage dysfunction may be an integral part of xenobiotic-induced immunosuppression and that the effector but not affector component of macrophage function may be the site of alteration. PMID:7238456

  9. Thapsigargin Triggers Cardiac Contractile Dysfunction via NADPH Oxidase -Mediated Mitochondrial Dysfunction: Role of Akt Dephosphorylation

    PubMed Central

    Zhang, Yingmei; Ren, Jun

    2011-01-01

    ER stress triggers myocardial contractile dysfunction although the underlying mechanism is still elusive. Given that NADPH oxidase was recently implicated in ER stress-induced tissue injury, this study was designed to examine the role of NADPH oxidase in the ER stress-induced cardiac mechanical defects and the impact of Akt activation on ER stress-induced cardiac anomalies. WT and transgenic mice with cardiac-specific overexpression of active mutant of Akt (MyAkt) were subjected to the ER stress inducer thapsigargin (1 and 3 mg/kg, i.p. for 48 hr). Thapsigargin compromised echocardiographic parameters including elevated LVESD and reduced fractional shortening, suppressed cardiomyocyte contractile function, intracellular Ca2+ handling and cell survival, along with enhanced carbonyl formation, apoptosis, superoxide production, NADPH oxidase expression and mitochondrial damage. Interestingly, these anomalies were attenuated or mitigated by chronic Akt activation. Treatment with thapsigargin also dephosphorylated Akt and its downstream signal GSK3? (leading to activation of GSK3?), the effect of which was abrogated in MyAkt hearts. Knockdown of cytosolic subunit of NADPH oxidase p47phox using siRNA abrogated thapsigargin-induced apoptosis and cell death in H9C2 myoblasts. In vitro exposure of thapsigargin induced murine cardiomyocyte dysfunction reminiscent of the in vivo setting, the effects of which were ablated by the NADPH oxidase inhibitor apocynin and the mitochondrial Ca2+ uptake inhibitor Ru360. In addition, apocynin abrogated thapsigargin-induced loss of mitochondrial membrane potential and permeation pore opening, similar to those induced by chronic Akt activation. In summary, these data suggest that ER stress interrupts cardiac contractile and intracellular Ca2+ homeostasis, cell survival and mitochondrial integrity through an Akt dephosphorylation and NADPH oxidase-dependent mechanism. PMID:21996563

  10. Obesity accelerates cognitive decline by aggravating mitochondrial dysfunction, insulin resistance and synaptic dysfunction under estrogen-deprived conditions.

    PubMed

    Pratchayasakul, Wasana; Sa-Nguanmoo, Piangkwan; Sivasinprasasn, Sivaporn; Pintana, Hiranya; Tawinvisan, Rungroj; Sripetchwandee, Jirapas; Kumfu, Sirinart; Chattipakorn, Nipon; Chattipakorn, Siriporn C

    2015-06-01

    Chronic consumption of a high-fat diet (HF) causes peripheral insulin resistance, brain insulin resistance, brain mitochondrial dysfunction and cognitive impairment. Estrogen deprivation has also been found to impair cognition. However, the combined effect of both conditions on the brain is unclear. We hypothesized that estrogen deprivation causes brain insulin resistance, brain mitochondrial dysfunction, hippocampal synaptic dysfunction and cognitive impairment, and that consumption of a HF accelerates these impairments in an estrogen-deprived condition. Seventy-two female rats were divided into sham (S) and ovariectomized (O) groups. Rats in each group were further divided into two subgroups to be fed with either a normal diet (ND) or HF for 4, 8 and 12weeks. At the end of each period, the Morris water maze test was carried out, after which the blood and brain were collected for metabolic and brain function analysis. Obesity, peripheral insulin resistance, increased brain oxidative stress and hippocampal synaptic dysfunction were observed at the eighth week in the NDO, HFS and HFO rats. However, these impairments were worse in the HFO rats. Interestingly, brain insulin resistance, brain mitochondrial dysfunction and cognitive impairment developed earlier (week eight) in the HFO rats, whereas these conditions were observed later at week 12 in the NDO and HFS rats. Either estrogen deprivation or HF appears to cause peripheral insulin resistance, increased brain oxidative stress, hippocampal synaptic dysfunction, brain mitochondrial dysfunction and brain insulin resistance, which together can lead to cognitive impairment. A HF accelerates and aggravates these deleterious effects under estrogen-deprived conditions. PMID:25989597

  11. Protective role of melatonin in mitochondrial dysfunction and related disorders.

    PubMed

    Paradies, Giuseppe; Paradies, Valeria; Ruggiero, Francesca M; Petrosillo, Giuseppe

    2015-06-01

    Mitochondria are the powerhouse of the eukaryotic cell through their use of oxidative phosphorylation to generate ATP. Mitochondrial dysfunction is considered an important contributing factor in a variety of physiopathological situations such as aging, heart ischemia/reperfusion injury, diabetes and several neurodegenerative and cardiovascular diseases, as well as in cell death. Increased formation of reactive oxygen species, altered respiratory chain complexes activity and opening of the mitochondrial permeability transition pore have been suggested as possible factors responsible for impaired mitochondrial function. Therefore, preventing mitochondrial dysfunction could be an effective therapeutic strategy against cellular degenerative processes. Cardiolipin is a unique phospholipid located at the level of inner mitochondrial membrane where it plays an important role in mitochondrial bioenergetics, as well as in cell death. Cardiolipin abnormalities have been associated with mitochondrial dysfunction in a variety of pathological conditions and aging. Melatonin, the major secretory product of the pineal gland, is a well-known antioxidant agent and thus an effective protector of mitochondrial bioenergetic function. Melatonin was reported to prevent mitochondrial dysfunction from oxidative damage by preserving cardiolipin integrity, and this may explain, at least in part, the beneficial effect of this compound in mitochondrial physiopathology. In this article, mechanisms through which melatonin exerts its protective role in mitochondrial dysfunction and related disorders are reviewed. PMID:25690732

  12. Depression, Poor Sleep, and Sexual Dysfunction in Migraineurs Women

    PubMed Central

    Ghajarzadeh, Mahsa; Jalilian, Rozita; Togha, Mansoureh; Azimi, Amirreza; Hosseini, Pegah; Babaei, Nazanin

    2014-01-01

    Background: Migraine is a chronic disorder affecting women more than men. Sexual dysfunction is one the complaints of women with migraine, which is not regarded as it should be. The goal of this study was to determine sexual dysfunction in women with migraine, and possible effects of depression and sleep quality on their sexual function. Methods: One hundred married migraineurs women were enrolled. All participants were asked to fill out valid and reliable Persian versions of Pittsburgh Sleep Questionnaire (PSQI), female sexual function index (FSFI) and beck depression inventory (BDI). Results: Mean BDI, PSQI, and FSFI scores were 15.1 ± 9.1, 7.6 ± 4, and 21.6 ± 8.8 in all patients, respectively. Sexual dysfunction found in 68% and 79% were poor sleepers. Mean BDI and PSQI scores were significantly higher in women with sexual dysfunction (FSFI < 26.55). There was significant negative correlation between BDI score and FSFI (r = ?0.1, P = 0.001) as well as significant positive correlation between BDI and PSQI (r = 0.42, P < 0.001). Multiple linear regression analysis showed that BDI and age were independent predictors of FSFI score. Conclusions: Physicians should consider sexual dysfunction in women with migraine along with depression and poor sleep in such cases. PMID:25317293

  13. Sexual dysfunction and marital satisfaction among the chemically injured veterans

    PubMed Central

    Ahmadi, Khodabakhsh; Ranjebar-Shayan, Hossein; Raiisi, Fateme

    2007-01-01

    Introduction: Researches show that chronic illnesses may affect marital adjustment and sexual function. Therefore, the purpose of this research was to recognize marital satisfaction, sexual dysfunction and demographic factors among Chemically Injured Veterans (CIV). Materials and Methods: In this descriptive research, we selected and studied 185 cases of CIVs referred to Tehran's hospitals. Data gathering tools were Enrich Marital Satisfaction Scale and structured interview. The items of interview included 28 questions about sexual dysfunction according to DSM-IV-r. The statistical methods were T-test, ANOVA and Correlation. Results: The results show that 45.5%, i.e. nearly half of the CIV subjects were dissatisfied with their marriage and marital relationship and the dissatisfaction level in 11% was very high. Other results show that 65/4% of veterans with chemical injuries suffered from a kind of sexual dysfunction. The most common dysfunctions were: erectile problem and libido reduction by 49.2% and 48.6% respectively. Also, results show that there was a relation between demographic factors and sexual dysfunction in CIVs. Discussion: As far as the results show, sexual libido reduction rate in CIVs is like that in chronic obstructive pulmonary disease patients. Therefore, sex therapy, psychotherapy and couple therapy must be a component of the treatment of CIVs. PMID:19718292

  14. Cognitive and emotional predictors of female sexual dysfunctions: preliminary findings.

    PubMed

    Nobre, Pedro J; Pinto-Gouveia, Jose

    2008-01-01

    The influence of cognitive and emotional variables on specific female sexual dysfunctions was investigated. A total of 207 women (160 without sexual problems and 47 with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of sexual dysfunction) answered a set of questionnaires assessing cognitive and emotional variables (cognitive schemas activated in sexual context - Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC); sexual beliefs - Sexual Dysfunctional Beliefs Questionnaire (SDBQ); automatic thoughts and emotions presented during sexual activity - Sexual Modes Questionnaire (SMQ)); and sexual functioning (Female Sexual Function Index (FSFI)). Results indicated that most women with sexual dysfunction activate incompetence schemas when facing unsuccessful sexual situations. Additionally, lack of erotic thoughts and increased attentional focus on failure and disengagement thoughts during sexual activity were also common in the clinical sample. Besides these common factors, results showed that some specific cognitive and emotional factors are associated with different clinical presentations. Sexual conservative beliefs seem to be closely related to hypoactive sexual desire and to a certain extent to arousal difficulties in women. Body image beliefs and automatic thoughts focusing on self-body appearance seem to be strongly associated with orgasmic disorder. Regarding emotions, fear was one of the best predictors of vaginismus, whereas sadness, disillusion, guilt, and lack of pleasure and satisfaction were closely associated to hypoactive sexual desire. Overall, these findings may contribute to the discussion regarding the treatment strategies used for the different female sexual dysfunctions. PMID:18576234

  15. Myosin Light Chain Kinase Signaling in Endothelial Barrier Dysfunction

    PubMed Central

    Rigor, Robert R.; Shen, Qiang; Pivetti, Christopher D.; Wu, Mack H.; Yuan, Sarah Y.

    2013-01-01

    Microvascular barrier dysfunction is a serious problem that occurs in many inflammatory conditions, including sepsis, trauma, ischemia–reperfusion injury, cardiovascular disease, and diabetes. Barrier dysfunction permits extravasation of serum components into the surrounding tissue, leading to edema formation and organ failure. The basis for microvascular barrier dysfunction is hyperpermeability at endothelial cell–cell junctions. Endothelial hyperpermeability is increased by actomyosin contractile activity in response to phosphorylation of myosin light chain by myosin light chain kinase (MLCK). MLCK-dependent endothelial hyperpermeability occurs in response to inflammatory mediators (e.g., activated neutrophils, thrombin, histamine, tumor necrosis factor alpha, etc.), through multiple cell signaling pathways and signaling molecules (e.g., Ca++, protein kinase C, Src kinase, nitric oxide synthase, etc.). Other signaling molecules protect against MLCK-dependent hyperpermeability (e.g., sphingosine-1-phosphate or cAMP). In addition, individual MLCK isoforms play specific roles in endothelial barrier dysfunction, suggesting that isoform-specific inhibitors could be useful for treating inflammatory disorders and preventing multiple organ failure. Because endothelial barrier dysfunction depends upon signaling through MLCK in many instances, MLCK-dependent signaling comprises multiple potential therapeutic targets for preventing edema formation and multiple organ failure. The following review is a discussion of MLCK-dependent mechanisms and cell signaling events that mediate endothelial hyperpermeability. PMID:22886693

  16. Mitochondrial dysfunction and intracellular calcium dysregulation in ALS

    PubMed Central

    Kawamata, Hibiki; Manfredi, Giovanni

    2010-01-01

    Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder that affects the aging population. A progressive loss of motor neurons in the spinal cord and brain leads to muscle paralysis and death. As in other common neurodegenerative diseases, aging-related mitochondrial dysfunction is increasingly being considered among the pathogenic factors. Mitochondria are critical for cell survival: they provide energy to the cell, buffer intracellular calcium, and regulate apoptotic cell death. Whether mitochondrial abnormalities are a trigger or a consequence of the neurodegenerative process and the mechanisms whereby mitochondrial dysfunction contributes to disease are not clear yet. Calcium homeostasis is a major function of mitochondria in neurons, and there is ample evidence that intracellular calcium is dysregulated in ALS. The impact of mitochondrial dysfunction on intracellular calcium homeostasis and its role in motor neuron demise are intriguing issues that warrants in depth discussion. Clearly, unraveling the causal relationship between mitochondrial dysfunction, calcium dysregulation, and neuronal death is critical for the understanding of ALS pathogenesis. In this review, we will outline the current knowledge of various aspects of mitochondrial dysfunction in ALS, with a special emphasis on the role of these abnormalities on intracellular calcium handling. PMID:20493207

  17. Should all women be screened for thyroid dysfunction in pregnancy?

    PubMed

    Taylor, Peter N; Okosieme, Onyebuchi E; Premawardhana, Lakdasa; Lazarus, John H

    2015-06-01

    The subject of universal thyroid screening in pregnancy generates impassioned debate. Thyroid dysfunction is common, has significant adverse implications for fetal and maternal well-being, is readily detectable and can be effectively and inexpensively treated. Furthermore, the currently recommended case-finding strategy does not identify a substantially proportion of women with thyroid dysfunction thus favoring universal screening. On the other hand subclinical thyroid dysfunction forms the bulk of gestational thyroid disorders and the paucity of high-level evidence to support correction of these asymptomatic biochemical abnormalities weighs against universal screening. This review critically appraises the literature, examines the pros and cons of universal thyroid screening in pregnancy, highlighting the now strong case for implementing universal screening and explores strategies for its implementation. PMID:26102469

  18. Coronary microvascular dysfunction: sex-specific risk, diagnosis, and therapy.

    PubMed

    Dean, Jenna; Cruz, Sherwin Dela; Mehta, Puja K; Merz, C Noel Bairey

    2015-07-01

    Cardiovascular disease is the leading cause of death worldwide. In the presence of signs and symptoms of myocardial ischaemia, women are more likely than men to have no obstructive coronary artery disease (CAD). Women have a greater burden of symptoms than men, and are often falsely reassured despite the presence of ischaemic heart disease because of a lack of obstructive CAD. Coronary microvascular dysfunction should be considered as an aetiology for ischaemic heart disease with signs and symptoms of myocardial ischaemia, but no obstructive CAD. Coronary microvascular dysfunction is defined as impaired coronary flow reserve owing to functional and/or structural abnormalities of the microcirculation, and is associated with an adverse cardiovascular prognosis. Therapeutic lifestyle changes as well as antiatherosclerotic and antianginal medications might be beneficial, but clinical outcome trials are needed to guide treatment. In this Review, we discuss the prevalence, presentation, diagnosis, and treatment of coronary microvascular dysfunction, with a particular emphasis on ischaemic heart disease in women. PMID:26011377

  19. [Questionnaires on male sexual dysfunction and their clinical application].

    PubMed

    Cai, Yang; Wang, Tao; Liu, Ji-Hong

    2014-09-01

    With the increasing incidence and prevalence of male sexual dysfunction, andrologists are more and more in need of accurate and efficient tools to assess therapeutic efficacy and patients' satisfaction and to help patients achieve satisfactory treatment results. This article summarizes some of the most commonly used questionnaires for the diagnosis and assessment of the treatment of male sexual dysfunction, including International Index of Erectile Function (IIEF), Erection Hardness Score (EHS), Quality of Erection Questionnaire (QEQ), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Treatment Satisfaction Scale (TSS), Self-Esteem and Relationship (SEAR), Premature Ejaculation Profile (PEP), Premature Ejaculation Diagnostic Tool (PEDT), Index of Premature Ejaculation (IPE), Arabic Index of Premature Ejaculation (AIPE), Aging Male Symptoms Scale (AMS), Androgen Deficiency in the Aging Male (ADAM), and Symptomatic Inventory for Screening Late-Onset Hypogonadism in Males (SILOH), and presents an overview on their clinical application. PMID:25306815

  20. Dysfunctional cognitive appraisal and psychophysiological reactivity in acute stress disorder.

    PubMed

    Elsesser, Karin; Freyth, Claudia; Lohrmann, Thomas; Sartory, Gudrun

    2009-10-01

    The present study investigated the extent of dysfunctional appraisal as measured with the Posttraumatic Cognitions Inventory (PTCI) and physiological responses to trauma-related material in patients with acute stress disorder (ASD; N=44) in comparison to participants without trauma exposure (N=27). Heart-rate (HR), skin conductance responses (SCR), and viewing time were recorded in response to - for trauma victims - idiosyncratically trauma-relevant and control pictures. ASD patients evidenced greater dysfunctional appraisal than control participants with regard to the PTCI scales Self and World and also an accelerative HR reaction and greater SCRs to trauma-relevant pictures. Among patients, PTCI was highly correlated with ASD severity while PTCI World was positively correlated with resting HR and depression. Amplitude of the HR reaction to trauma-related pictures was negatively correlated with viewing time. Results suggest that dysfunctional appraisal and autonomic reactivity are only loosely related in ASD. PMID:19604667

  1. Rise of herbal and traditional medicine in erectile dysfunction management.

    PubMed

    Ho, Christopher C K; Tan, Hui Meng

    2011-12-01

    Herbal medicine long has been used in the management of sexual dysfunction, including erectile dysfunction. Many patients have attested to the efficacy of this treatment. However, is it evidence-based medicine? Studies have been done on animal models, mainly in the laboratory. However, randomized controlled trials on humans are scarce. The only herbal medications that have been studied for erectile dysfunction are Panax ginseng, Butea superba, Epimedium herbs (icariin), Tribulus terrestris, Securidaca longipedunculata, Piper guineense, and yohimbine. Of these, only Panax ginseng, B. superb, and yohimbine have published studies done on humans. Unfortunately, these published trials on humans were not robust. Many herbal therapies appear to have potential benefits, and similarly, the health risks of various phytotherapeutic compounds need to be elucidated. Properly designed human trials should be worked out and encouraged to determine the efficacy and safety of potential phytotherapies. PMID:21948222

  2. Late Kidney Dysfunction in a Kidney Transplant Recipient

    PubMed Central

    2014-01-01

    Late kidney transplant dysfunction may be a harbinger of graft failure. For many years, calcineurin inhibitor toxicity was felt to be the main cause for graft dysfunction with fibrosis and transplant loss. Recently this idea has come into question. With the observation that peritubular capillary C4d staining in kidney allografts may indicate antibody-mediated injury in conjunction with biopsy study findings, an appreciation for antibody-mediated rejection as a major cause of late graft dysfunction and loss has emerged. Twenty percent to 30% of patients develop de novo donor-specific antibodies after kidney transplantation. There are no US Food and Drug Administration–approved treatments for antibody-mediated rejection, nor have any randomized controlled trials assessed efficacy. Off-label treatment strategies include some combination of plasma exchange, intravenous immunoglobulin, and rituximab. Other approaches, including splenectomy, bortezomib, and eculizumab, have also been tried. PMID:24370771

  3. Nitric oxide dysfunction in the pathophysiology of preeclampsia.

    PubMed

    Lowe, D T

    2000-08-01

    Researchers disagree as to the importance of nitric oxide (NO) in preeclampsia. Many researchers have alluded to NO's possible primary or secondary role in the development of preeclampsia, but few have correlated the dysfunction of nitric oxide production with the other metabolic derangements seen in this condition. This paper will review the evidence that the primary dysfunction in preeclampsia is a relative deficiency of available NO (secondary to oxidative degradation) and an excess of peroxynitrite (ONOO(-)). The combination of a deficiency of NO and an increase in ONOO(-) can directly or indirectly initiate the vast majority of physiological and serological changes associated with preeclampsia, such as blood pressure, increased glomerular filtration rate, proteinuria, platelet dysfunction, increased thromboxane and endothelin, and a decrease in prostacyclin. Understanding the complex role of nitric oxide in this condition may explain why previous interventions have been unsuccessful and suggest possible strategies for prevention and treatment in the future. PMID:10944429

  4. The biostatistical theory versus the harmful dysfunction analysis, part 1: is part-dysfunction a sufficient condition for medical disorder?

    PubMed

    Wakefield, Jerome C

    2014-12-01

    Christopher Boorse's biostatistical theory of medical disorder claims that biological part-dysfunction (i.e., failure of an internal mechanism to perform its biological function), a factual criterion, is both necessary and sufficient for disorder. Jerome Wakefield's harmful dysfunction analysis of medical disorder agrees that part-dysfunction is necessary but rejects the sufficiency claim, maintaining that disorder also requires that the part-dysfunction causes harm to the individual, a value criterion. In this paper, I present two considerations against the sufficiency claim. First, I analyze Boorse's central argument for the sufficiency claim, the "pathologist argument," which takes pathologists' intuitions about pathology as determinative of medical disorder and conclude that it begs the question and fails to support the sufficiency claim. Second, I present four counterexamples from the medical literature in which salient part-dysfunctions are considered nondisorders, including healthy disease carriers, HIV-positive status, benign mutations, and situs inversus totalis, thus falsifying the sufficiency claim and supporting the harm criterion. PMID:25336733

  5. IS THERE A RELATION BETWEEN SHOULDER DYSFUNCTION AND CORE INSTABILITY?

    PubMed Central

    Francis, Jennifer; Green, Andrew; Kahl, Eric; Maciurzynski, Diane; Quartulli, Ashley; Schultheiss, Julianne; Strang, Ryan; Weiss, Brett

    2014-01-01

    Background: Overhead athletes often suffer injury to the glenohumeral joint secondary to inherent instability. However, little is known about the relationship between core stability and shoulder dysfunction among athletes. Purpose: The purpose of this study was to analyze the difference between healthy athletes and those with shoulder dysfunction in regard to core stability measures. Secondary purpose was to explore the relationship between measures of core stability and measures of shoulder dysfunction. Methods: Participants consisted of NCAA Division III overhead athletes (28 males, 33 females) with a mean age of 19.3 ± (1.1) years, mean weight of 173.6 ± (36.9) pounds, mean height of 67.8 ± (3.5) inches. Functional questionnaires (the Kerlan?Jobe Orthopaedic Clinical Scale [KJOC] and the QuickDASH sports module) as well as Single?Leg Stance Balance Test (SLBT), Double Straight Leg Lowering Test (DLL), Sorensen Test, and Modified Side Plank Test were completed in a randomized order with consistent raters. Results: MANOVA was significant at (p = .038) for the comparison between the experimental group and the control group for the values of Right SLBT. The experimental group had significantly less balance than the control group with means of 10.14 ± (5.76) seconds and 18.98 ± (15.22) seconds respectively. Additionally, a positive correlation was found between the DLL and the KJOC at (r = .394, p > .05) and a negative correlation was found between the Right SLBT and the Quick DASH sports module (QD) at (r = –.271, p > .05). Discussion and Conclusion: Balance deficiency was found in athletes with shoulder dysfunction. According to this study, greater shoulder dysfunction is correlated with greater balance and stability deficiency. Therapists and trainers should consider incorporating balance training as an integral component of core stability into rehabilitation of athletes with shoulder dysfunction. Level of Evidence: 3b PMID:24567850

  6. Copeptin in Hemodialysis Patients with Left Ventricular Dysfunction

    PubMed Central

    Kim, Jae Seok; Yang, Jae Won; Chai, Moon Hee; Lee, Jun Young; Park, Hyeoncheol; Kim, Youngsub; Choi, Seung Ok

    2015-01-01

    Purpose Copeptin has been considered as a useful marker for diagnosis and prediction of prognosis in heart diseases. However, copeptin has not been investigated sufficiently in hemodialysis patients. This study aimed to investigate the general features of copeptin in hemodialysis and to examine the usefulness of copeptin in hemodialysis patients with left ventricular dysfunction (LV dysfunction). Materials and Methods This study included 41 patients on regular hemodialysis. Routine laboratory data and peptides such as the N-terminal of the prohormone brain natriuretic peptide and copeptin were measured on the day of hemodialysis. Body fluid volume was estimated by bioimpedance spectroscopy, and the E/Ea ratio was estimated by echocardiography. Results Copeptin increased to 171.4 pg/mL before hemodialysis. The copeptin had a positive correlation with pre-dialysis body fluid volume (r=0.314; p=0.04). The copeptin level decreased along with body fluid volume and plasma osmolality during hemodialysis. The copeptin increased in the patients with LV dysfunction more than in those with normal LV function (218.7 pg/mL vs. 77.6 pg/mL; p=0.01). Receiver operating characteristic curve analysis showed that copeptin had a diagnostic value in the hemodialysis patients with LV dysfunction (area under curve 0.737; p=0.02) and that the cut-off value was 125.48 pg/mL (sensitivity 0.7, specificity 0.8, positive predictive value 0.9, negative predictive value 0.6). Conclusion Copeptin increases in hemodialysis patients and is higher in patients with LV dysfunction. We believe that copeptin can be a useful marker for the diagnosis of LV dysfunction in hemodialysis patients. PMID:26069119

  7. [Peripheral muscle dysfunction in chronic obstructive pulmonary disease].

    PubMed

    Maltais, F; Leblanc, P; Jobin, J; Casaburi, R

    2002-09-01

    Patients with chronic obstructive pulmonary disease (COPD) often develop systemic complications of their disease. Peripheral muscle dysfunction is one such complication and is characterised by atrophy, weakness, and low oxidative capacity. These muscle changes influence exercise tolerance and quality of life independent of the impairment in lung function. In the following article, the evidence for peripheral muscle dysfunction in patients with COPD and the possible clinical implications of this problem will be discussed. Lastly, the available therapeutic options to improve peripheral muscle function in COPD will be reviewed. PMID:12417861

  8. Tetrahydrobiopterin improves diastolic dysfunction by reversing changes in myofilament properties.

    PubMed

    Jeong, Euy-Myoung; Monasky, Michelle M; Gu, Lianzhi; Taglieri, Domenico M; Patel, Bindiya G; Liu, Hong; Wang, Qiongying; Greener, Ian; Dudley, Samuel C; Solaro, R John

    2013-03-01

    Despite the increasing prevalence of heart failure with preserved left ventricular function, there are no specific treatments, partially because the mechanism of impaired relaxation is incompletely understood. Evidence indicates that cardiac relaxation may depend on nitric oxide (NO), generated by NO synthase (NOS) requiring the co-factor tetrahydrobiopterin (BH(4)). Recently, we reported that hypertension-induced diastolic dysfunction was accompanied by cardiac BH(4) depletion, NOS uncoupling, a depression in myofilament cross-bridge kinetics, and S-glutathionylation of myosin binding protein C (MyBP-C). We hypothesized that the mechanism by which BH(4) ameliorates diastolic dysfunction is by preventing glutathionylation of MyBP-C and thus reversing changes of myofilament properties that occur during diastolic dysfunction. We used the deoxycorticosterone acetate (DOCA)-salt mouse model, which demonstrates mild hypertension, myocardial oxidative stress, and diastolic dysfunction. Mice were divided into two groups that received control diet and two groups that received BH(4) supplement for 7days after developing diastolic dysfunction at post-operative day 11. Mice were assessed by echocardiography. Left ventricular papillary detergent-extracted fiber bundles were isolated for simultaneous determination of force and ATPase activity. Sarcomeric protein glutathionylation was assessed by immunoblotting. DOCA-salt mice exhibited diastolic dysfunction that was reversed after BH(4) treatment. Diastolic sarcomere length (DOCA-salt 1.70±0.01 vs. DOCA-salt+BH(4) 1.77±0.01?m, P<0.001) and relengthening (relaxation constant, ?, DOCA-salt 0.28±0.02 vs. DOCA-salt+BH(4) 0.08±0.01, P<0.001) were also restored to control by BH(4) treatment. pCa(50) for tension increased in DOCA-salt compared to sham but reverted to sham levels after BH(4) treatment. Maximum ATPase rate and tension cost (?ATPase/?Tension) decreased in DOCA-salt compared to sham, but increased after BH(4) treatment. Cardiac MyBP-C glutathionylation increased in DOCA-salt compared to sham, but decreased with BH(4) treatment. MyBP-C glutathionylation correlated with the presence of diastolic dysfunction. Our results suggest that by depressing S-glutathionylation of MyBP-C, BH(4) ameliorates diastolic dysfunction by reversing a decrease in cross-bridge turnover kinetics. These data provide evidence for modulation of cardiac relaxation by post-translational modification of myofilament proteins. PMID:23247392

  9. [Comprehensive diagnostics of the patients presenting with Eustachian tube dysfunction].

    PubMed

    Litovets, T S; Litovets, I I; Krasnozhen, V N; Mikha?lov, M K

    2013-01-01

    The objective of the present work was comprehensive diagnostics of Eustachian tube dysfunction as exemplified by 82 patients with this disorder. The examination using the standard techniques was supplemented by active anterior rhinomanometry, audiometry, and tympanometry. Three-dimensional computed tomography (3D X-ray CT) was used for detailed diagnostics of the state of the nasal structures and paranasal sinuses. The study has demonstrated that 96.3% of the patients with Eustachian tube dysfunction suffer a concomitant pathology of the paranasal sinuses, nasal cavity, and nasopharynx. Difficulties of nasal breathing were experienced by 62% of the patients. PMID:24300766

  10. Survivorship: sexual dysfunction (male), version 1.2013.

    PubMed

    Denlinger, Crystal S; Carlson, Robert W; Are, Madhuri; Baker, K Scott; Davis, Elizabeth; Edge, Stephen B; Friedman, Debra L; Goldman, Mindy; Jones, Lee; King, Allison; Kvale, Elizabeth; Langbaum, Terry S; Ligibel, Jennifer A; McCabe, Mary S; McVary, Kevin T; Melisko, Michelle; Montoya, Jose G; Mooney, Kathi; Morgan, Mary Ann; O'Connor, Tracey; Paskett, Electra D; Raza, Muhammad; Syrjala, Karen L; Urba, Susan G; Wakabayashi, Mark T; Zee, Phyllis; McMillian, Nicole; Freedman-Cass, Deborah

    2014-03-01

    Various anticancer treatments, especially those directed toward the pelvis, can damage blood vessels and reduce circulation of blood to the penis and/or damage the autonomic nervous system, resulting in higher rates of erectile dysfunction in survivors than in the general population. In addition, hormonal therapy can contribute to sexual problems, as can depression and anxiety, which are common in cancer survivors. This section of the NCCN Guidelines for Survivorship provides screening, evaluation, and treatment recommendations for male sexual problems, namely erectile dysfunction. PMID:24616541

  11. Epidermal barrier dysfunction and cutaneous sensitization in atopic diseases

    PubMed Central

    Kubo, Akiharu; Nagao, Keisuke; Amagai, Masayuki

    2012-01-01

    Classic atopic dermatitis is complicated by asthma, allergic rhinitis, and food allergies, cumulatively referred to as atopic diseases. Recent discoveries of mutations in the filaggrin gene as predisposing factors for atopic diseases have refocused investigators’ attention on epidermal barrier dysfunction as a causative mechanism. The skin’s barrier function has three elements: the stratum corneum (air-liquid barrier), tight junctions (liquid-liquid barrier), and the Langerhans cell network (immunological barrier). Clarification of the molecular events underpinning epidermal barrier function and dysfunction should lead to a better understanding of the pathophysiological mechanisms of atopic diseases. PMID:22293182

  12. Posterior tibial tendon dysfunction in the adult: current concepts.

    PubMed

    Stein, Benjamin E; Schon, Lew C

    2015-01-01

    The management of posterior tibial tendon dysfunction in adults has evolved substantially, and controversy persists regarding a specific recommended algorithm for treatment. The current focus is on early diagnosis and treatment of this disorder with joint-sparing surgeries, such as corrective osteotomies and tendon transfers, when nonsurgical modalities have been exhausted. It is helpful to be familiar with the pertinent pathophysiology and diagnostic pearls associated with posterior tibial tendon dysfunction, its treatment options, pertinent literature, and technique tips for the procedures currently being used. PMID:25745927

  13. Primary Orgasmic Dysfunction: Diagnostic Considerations and Review of Treatment

    PubMed Central

    Andersen, Barbara L.

    2009-01-01

    As a diagnostic category, primary orgasmic dysfunction includes all women who have never experienced orgasm under any circumstances except sleep or fantasy. However, the research samples of nonorgasmic women in clinical reports and empirical investigations are heterogeneous with regard to disruption of earlier phases of the sexual response cycle and emotional concomitants of the dysfunction. The major treatment models—systematic desensitization, sensate focus, directed masturbation, and hypnosis—are presented, and empirical support is reviewed. Separate discussion is included for investigations comparing treatment modalities. Finally, a strategy for future programmatic sex therapy research is suggested within the broader context of psychotherapy outcome research. PMID:6828600

  14. Gastrointestinal Autonomic Dysfunction in Patients with Parkinson’s Disease

    PubMed Central

    Kim, Joong-Seok; Sung, Hye-Young

    2015-01-01

    Currently, gastrointestinal dysfunctions in Parkinson’s disease (PD) are well-recognized problems and are known to be an initial symptom in the pathological process that eventually results in PD. Gastrointestinal symptoms may result from the involvement of either the central or enteric nervous systems, or these symptoms may be side effects of antiparkinsonian medications. Weight loss, excessive salivation, dysphagia, nausea/gastroparesis, constipation, and defecation dysfunction all may occur. Increased identification and early detection of these symptoms can result in a significant improvement in the quality of life for PD patients. PMID:26090079

  15. Tetrahydrobiopterin improves diastolic dysfunction by reversing changes in myofilament properties

    PubMed Central

    Jeong, Euy-Myoung; Monasky, Michelle M.; Gu, Lianzhi; Taglieri, Domenico M.; Patel, Bindiya G.; Liu, Hong; Wang, Qiongying; Greener, Ian; Dudley, Samuel C.; Solaro, R. John

    2013-01-01

    Despite the increasing prevalence of heart failure with preserved left ventricular function, there are no specific treatments, partially because the mechanism of impaired relaxation is incompletely understood. Evidence indicates that cardiac relaxation may depend on nitric oxide (NO), generated by NO synthase (NOS) requiring the co-factor tetrahydrobiopterin (BH4). Recently, we reported that hypertension-induced diastolic dysfunction was accompanied by cardiac BH4 depletion, NOS uncoupling, a depression in myofilament cross-bridge kinetics, and S-glutathionylation of myosin binding protein C (MyBP-C). We hypothesized that the mechanism by which BH4 ameliorates diastolic dysfunction is by preventing glutathionylation of MyBP-C and thus reversing changes of myofilament properties that occur during diastolic dysfunction. We used the deoxycorticosterone acetate (DOCA)-salt mouse model, which demonstrates mild hypertension, myocardial oxidative stress, and diastolic dysfunction. Mice were divided into two groups that received control diet and two groups that received BH4 supplement for 7 days after developing diastolic dysfunction at post-operative day 11. Mice were assessed by echocardiography. Left ventricular papillary detergent-extracted fiber bundles were isolated for simultaneous determination of force and ATPase activity. Sarcomeric protein glutathionylation was assessed by immunoblotting. DOCA-salt mice exhibited diastolic dysfunction that was reversed after BH4 treatment. Diastolic sarcomere length (DOCA-salt 1.70±0.01 vs. DOCA-salt+BH4 1.77±0.01 ?m, P<0.001) and relengthening (relaxation constant, ?, DOCA-salt 0.28±0.02 vs. DOCA-salt+BH4 0.08±0.01, P<0.001) were also restored to control by BH4 treatment. pCa50 for tension increased in DOCA-salt compared to sham but reverted to sham levels after BH4 treatment. Maximum ATPase rate and tension cost (?ATPase/?Tension) decreased in DOCA-salt compared to sham, but increased after BH4 treatment. Cardiac MyBP-C glutathionylation increased in DOCA-salt compared to sham, but decreased with BH4 treatment. MyBP-C glutathionylation correlated with the presence of diastolic dysfunction. Our results suggest that by depressing S-glutathionylation of MyBP-C, BH4 ameliorates diastolic dysfunction by reversing a decrease in cross-bridge turnover kinetics. These data provide evidence for modulation of cardiac relaxation by post-translational modification of myofilament proteins. PMID:23247392

  16. Autonomic dysfunction in multiple sclerosis: implications for exercise.

    PubMed

    Huang, Mu; Jay, Ollie; Davis, Scott L

    2015-03-01

    Multiple sclerosis (MS), a progressive neurological disease, can result in autonomic dysfunction. Impairments in the autonomic control of cardiovascular and thermoregulatory function during exercise have been observed in MS. Attenuated elevations in blood pressure during exercise in MS patients can negatively impact blood flow to skeletal muscle. Diminished sweating during exercise may impair heat dissipation likely limiting the exercise intensity that can be performed before detrimental core temperatures are reached. Further understanding the physiologic mechanisms of autonomic dysfunction during exercise in MS may lead to the development of novel therapeutic strategies targeted at improving quality of life in individuals with this disease. PMID:25458432

  17. Hypertension associated with massive, bilateral, posture-dependent renal dysfunction.

    PubMed

    Clorius, J H; Schmidlin, P; Raptou, E; Huber, W; Georgi, P

    1981-07-01

    Hippurate function scintiscans were obtained in prone and standing positions in a group of 76 patients with concurrent hypertension and nephroptosis. TWelve of these patients had massive, bilateral disturbance of intrarenal hippurate transport in the standing position; hippurate transport was normal in the prone position. This pattern was present in only three of 120 normotensive patients with nephroptosis. To investigate the importance of nephroptosis, 87 other hypertensive patients were examined. Eighteen of these patients demonstrated posture-dependent tubular dysfunction, but only four had nephroptosis. The results suggest a direct relationship between bilateral posture-dependent tubular dysfunction and hypertension. PMID:7244230

  18. Survivorship: Sexual Dysfunction (Male), Version 1.2013

    PubMed Central

    Denlinger, Crystal S.; Carlson, Robert W.; Are, Madhuri; Baker, K. Scott; Davis, Elizabeth; Edge, Stephen B.; Friedman, Debra L.; Goldman, Mindy; Jones, Lee; King, Allison; Kvale, Elizabeth; Langbaum, Terry S.; Ligibel, Jennifer A.; McCabe, Mary S.; McVary, Kevin T.; Melisko, Michelle; Montoya, Jose G.; Mooney, Kathi; Morgan, Mary Ann; O’Connor, Tracey; Paskett, Electra D.; Raza, Muhammad; Syrjala, Karen L.; Urba, Susan G.; Wakabayashi, Mark T.; Zee, Phyllis; McMillian, Nicole; Freedman-Cass, Deborah

    2015-01-01

    Various anticancer treatments, especially those directed toward the pelvis, can damage blood vessels and reduce circulation of blood to the penis and/or damage the autonomic nervous system, resulting in higher rates of erectile dysfunction in survivors than in the general population. In addition, hormonal therapy can contribute to sexual problems, as can depression and anxiety, which are common in cancer survivors. This section of the NCCN Guidelines for Survivorship provides screening, evaluation, and treatment recommendations for male sexual problems, namely erectile dysfunction. PMID:24616541

  19. Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis

    Microsoft Academic Search

    H. L. Tan; A. Najmaldin

    1993-01-01

    Although great advances in laparoscopic techniques have been made in the field of adult surgery, its application in infants and young children has been limited. We present a technique of laparoscopic pyloromyotomy that has been successfully used in two babies, employing specially made instruments. Laparoscopic surgery deserves further consideration in this age group.

  20. Dysfunction of reward processing correlates with alcohol craving in detoxified alcoholics

    E-print Network

    Knutson, Brian

    Dysfunction of reward processing correlates with alcohol craving in detoxified alcoholics Jana Objective: Alcohol dependence may be associated with dysfunction of mesolimbic circuitry, such that anticipation of nonalcoholic reward fails to activate the ventral striatum, while alcohol-associated cues

  1. Pediatric Physical Therapy: Part II. Approaches to Movement Dysfunction.

    ERIC Educational Resources Information Center

    Heriza, Carolyn B.; Sweeney, Jane K.

    1995-01-01

    This article, the second of a three-part series, outlines neuromuscular, musculoskeletal, and cardiopulmonary physical therapy approaches to movement dysfunction in children. The multiple roles of the pediatric physical therapist in teaching, consulting, managing, referring, and conducting clinical research are discussed. (Author/DB)

  2. Dysfunctional Attitudes and Suicidal Ideation in Psychiatric Outpatients.

    ERIC Educational Resources Information Center

    Beck, Aaron T.; And Others

    1993-01-01

    Administered Dysfunctional Attitude Scale (DAS), Beck Depression Inventory (BDI), Hopelessness Scale (BHS), Self-Concept Test (BST), and Scale for Suicide Ideation (SSI) to 908 psychiatric outpatients. Found that none of DAS subscales discriminated ideators and nonideators or was significantly related to SSI total scores of suicide ideators after…

  3. Mechanisms of autonomic nervous system dysfunction in uremia

    Microsoft Academic Search

    Vito M Campese; Mark S Romoff; Daniel Levitan; Shaul G Massry

    1981-01-01

    Mechanisms of autonomic nervous system dysfunction in uremia. Autonomic nervous system (ANS) function was evaluated in 60 normal subjects, 21 predialysis patients, 16 dialysis patients, and 15 patients with chronic illnesses and normal renal function by Valsalva ratio, hand-grip exercise, and response to orthostasis. Blood levels of norepinephrine (NE) and the response to NE infusion were also evaluated. Valsalva ratio

  4. Proteinuria-Associated Endothelial Dysfunction Is Strain Dependent

    Microsoft Academic Search

    Nadir Ulu; Regien G. Schoemaker; Robert H. Henning; Hendrik Buikema; Tom Teerlink; Freek J. Zijlstra; Stephan J. L. Bakker; Wiek H. van Gilst; Gerjan Navis

    2009-01-01

    Background: Proteinuria-associated endothelial dysfunction (ED) is assumed to play a main role in the cardiovascular morbidity in proteinuric patients. However, the connection between proteinuria and systemic endothelial function is not clear yet. Therefore, we studied aortic endothelial function in Munich Wistar Frömter (MWF) and fawn-hooded hypertensive (FHH) inbred rat strains with genetic proteinuria to determine the specific impact of proteinuria

  5. Severe erectile dysfunction is a marker for hyperprolactinemia

    Microsoft Academic Search

    AM Johri; JPW Heaton; A Morales

    2001-01-01

    The need for routine prolactin (PRL) measurement in the initial evaluation of erectile dysfunction (ED) has been questioned because of the low rate of hyperprolactinemia (HP) in these men and the costs involved. In addition, it is widely thought that sexual desire problems are a good clinical marker for HP and\\/or low testosterone in men with ED. Within a 15-month

  6. Late renal dysfunction in adult survivors of bone marrow transplantation

    SciTech Connect

    Lawton, C.A.; Cohen, E.P.; Barber-Derus, S.W.; Murray, K.J.; Ash, R.C.; Casper, J.T.; Moulder, J.E. (Medical College of Wisconsin Affiliated Hospitals, Milwaukee (USA))

    1991-06-01

    Until recently long-term renal toxicity has not been considered a major late complication of bone marrow transplantation (BMT). Late renal dysfunction has been described in a pediatric population status post-BMT which was attributable to the radiation in the preparatory regimen. A thorough review of adults with this type of late renal dysfunction has not previously been described. Fourteen of 103 evaluable adult patients undergoing allogeneic (96) or autologous (7) bone marrow transplantation, predominantly for leukemia and lymphomas, at the Medical College of Wisconsin (Milwaukee, WI) have had a syndrome of renal insufficiency characterized by increased serum creatinine, decreased glomerular filtration rate, anemia, and hypertension. This syndrome developed at a median of 9 months (range, 4.5 to 26 months) posttransplantation in the absence of specific identifiable causes. The cumulative probability of having this renal dysfunction is 20% at 1 year. Renal biopsies performed on seven of these cases showed the endothelium widely separated from the basement membrane, extreme thickening of the glomerular basement membrane, and microthrombi. Previous chemotherapy, antibiotics, and antifungals as well as cyclosporin may add to and possibly potentiate a primary chemoradiation marrow transplant renal injury, but this clinical syndrome is most analogous to clinical and experimental models of radiation nephritis. This late marrow transplant-associated nephritis should be recognized as a potentially limiting factor in the use of some intensive chemoradiation conditioning regimens used for BMT. Some selective attenuation of the radiation to the kidneys may decrease the incidence of this renal dysfunction.

  7. Sexual dysfunction among middle aged women in the community.

    PubMed

    Osborn, M; Hawton, K; Gath, D

    1988-04-01

    In a community survey of women aged 35-59 sexual functioning was studied in the 436 women with partners. One third of these women had operationally defined sexual dysfunction: impaired sexual interest was identified in 17% of women (68/406), vaginal dryness in 17% (73/434), infrequency of orgasm in 16% (60/379), and dyspareunia in 8% (30/379). Sexual dysfunctions were statistically significantly associated with increasing age and also with psychiatric disorder, neuroticism, and marital disharmony. One in 10 women regarded themselves as having a sexual problem. These women were no older than women with sexual dysfunction who did not regard themselves as having a sexual problem. Nevertheless, they differed from the rest of the sample in having more psychiatric disorder, neuroticism, marital disharmony, and (in women still menstruating) psychological symptoms of the premenstrual syndrome. In the whole sample 16 women (4%) said that they would like help for a sexual problem. The prevalence of sexual dysfunction in this series of women suggests that general practitioners should increase their alertness to the problem in their patients. PMID:3129108

  8. Unraveling biochemical pathways affected by mitochondrial dysfunctions using metabolomic approaches.

    PubMed

    Demine, Stéphane; Reddy, Nagabushana; Renard, Patricia; Raes, Martine; Arnould, Thierry

    2014-01-01

    Mitochondrial dysfunction(s) (MDs) can be defined as alterations in the mitochondria, including mitochondrial uncoupling, mitochondrial depolarization, inhibition of the mitochondrial respiratory chain, mitochondrial network fragmentation, mitochondrial or nuclear DNA mutations and the mitochondrial accumulation of protein aggregates. All these MDs are known to alter the capacity of ATP production and are observed in several pathological states/diseases, including cancer, obesity, muscle and neurological disorders. The induction of MDs can also alter the secretion of several metabolites, reactive oxygen species production and modify several cell-signalling pathways to resolve the mitochondrial dysfunction or ultimately trigger cell death. Many metabolites, such as fatty acids and derived compounds, could be secreted into the blood stream by cells suffering from mitochondrial alterations. In this review, we summarize how a mitochondrial uncoupling can modify metabolites, the signalling pathways and transcription factors involved in this process. We describe how to identify the causes or consequences of mitochondrial dysfunction using metabolomics (liquid and gas chromatography associated with mass spectrometry analysis, NMR spectroscopy) in the obesity and insulin resistance thematic. PMID:25257998

  9. Endothelial Dysfunction Abrogates the Efficacy of Normobaric Hyperoxia in Stroke

    PubMed Central

    Shin, Hwa Kyoung; Oka, Fumiaki; Kim, Ji Hyun; Atochin, Dmitriy; Huang, Paul L.

    2014-01-01

    Hyperoxia has been uniformly efficacious in experimental focal cerebral ischemia. However, pilot clinical trials have showed mixed results slowing its translation in patient care. To explain the discordance between experimental and clinical outcomes, we tested the impact of endothelial dysfunction, exceedingly common in stroke patients but under-represented in experimental studies, on the neuroprotective efficacy of normobaric hyperoxia. We used hyperlipidemic apolipoprotein E knock-out and endothelial nitric oxide synthase knock-out mice as models of endothelial dysfunction, and examined the effects of normobaric hyperoxia on tissue perfusion and oxygenation using high-resolution combined laser speckle and multispectral reflectance imaging during distal middle cerebral artery occlusion. In normal wild-type mice, normobaric hyperoxia rapidly and significantly improved tissue perfusion and oxygenation, suppressed peri-infarct depolarizations, reduced infarct volumes, and improved neurological function. In contrast, normobaric hyperoxia worsened perfusion in ischemic brain and failed to reduce infarct volumes or improve neurological function in mice with endothelial dysfunction. These data suggest that the beneficial effects of hyperoxia on ischemic tissue oxygenation, perfusion, and outcome are critically dependent on endothelial nitric oxide synthase function. Therefore, vascular risk factors associated with endothelial dysfunction may predict normobaric hyperoxia nonresponders in ischemic stroke. These data may have implications for myocardial and systemic circulation as well. PMID:25392489

  10. Associations of Functional and Dysfunctional Impulsivity to Smoking Characteristics

    PubMed Central

    Pitts, Stephanie R.; Leventhal, Adam M.

    2012-01-01

    Objectives Though the relation between impulsivity and smoking is well-documented, one model of impulsivity that has received little attention in the addiction literature separates impulsivity into two dimensions: functional impulsivity (tendency to make quick effective decisions) and dysfunctional impulsivity (tendency to make quick ineffective decisions). Methods This cross-sectional study examined relations of functional and dysfunctional impulsivity to smoking characteristics in 212 non-treatment-seeking daily smokers (M = 15 cig/day, M = age 24 years, 53% female). Results Dysfunctional impulsivity exhibited small to medium sized positive associations with difficulty refraining from smoking in forbidden places, craving, and smoking without awareness. Functional impulsivity was inversely associated with a measure of cigarette craving. Other suggestive associations were found; however, these were not statistically significant after type-I error correction. Conclusion Though the overall predictive validity of these impulsivity constructs for explaining variance in smoking characteristics was relatively modest, the results suggest that conceptualizing impulsivity as a unitary construct indicative of a tendency to make quick decisions may mask heterogeneity within the impulsivity-smoking relationship. These findings suggest that high-dysfunctional impulsivity smokers may perhaps require more intensive interventions to dampen motivation to smoke. They also highlight the possibility that certain manifestations of impulsivity are not related with increased smoking behavior and may actually associate with reduced drive to smoke. PMID:22864400

  11. Respiratory physiotherapy in the pulmonary dysfunction after cardiac surgery

    Microsoft Academic Search

    Julia Alencar RENAULT; Ricardo COSTA-VAL; Márcia Braz ROSSETTI

    The aim of this study is to make a literature review about the different techniques of respiratory physiotherapy used after cardiac surgery and their effectiveness in reverting pulmonary dysfunction. It has been used as reference publications in English and Portuguese using as keywords thoracic surgery, respiratory exercises, physiotherapy modalities, postoperative complications and coronary artery bypass grafting, contained in the following

  12. The Dysfunctional Nature of Political Systems in University Administration.

    ERIC Educational Resources Information Center

    Gunn, Bruce

    This paper argues that the rapid influx of information technology into society requires a change in university administration from the current political system to a computer based management system for higher productivity. The paper describes the dysfunctional nature of the political system of management in its lack of full accountability. The…

  13. Cognitive Visual Dysfunctions in Preterm Children with Periventricular Leukomalacia

    ERIC Educational Resources Information Center

    Fazzi, Elisa; Bova, Stefania; Giovenzana, Alessia; Signorini, Sabrina; Uggetti, Carla; Bianchi, Paolo

    2009-01-01

    Aim: Cognitive visual dysfunctions (CVDs) reflect an impairment of the capacity to process visual information. The question of whether CVDs might be classifiable according to the nature and distribution of the underlying brain damage is an intriguing one in child neuropsychology. Method: We studied 22 children born preterm (12 males, 10 females;…

  14. Vocal cord dysfunction after left lung resection for cancer

    Microsoft Academic Search

    Marc Filaire; Thierry Mom; Stéphanie Laurent; Yacouba Harouna; Adel Naamee; Laurent Vallet; Bernadette Normand; Georges Escande

    2001-01-01

    Objectives: To evaluate the prevalence, the impact-related postoperative complications and the risk factors of vocal cord dysfunction (VCD) after left lung resection for cancer. Methods: From February 1996 to April 1999, a review of prospectively gathered data was performed on 99 consecutive patients who underwent a pneumonectomy (n=50) or a lobectomy (n=49) with a mediastinal lymph node dissection. A fiber

  15. Vocal cord dysfunction after left lung resection for cancer

    Microsoft Academic Search

    Marc Filaire; Thierry Mom; Stephanie Laurent; Yacouba Harouna; Adel Naamee; Laurent Vallet; Bernadette Normand; Georges Escande

    Objectives: To evaluate the prevalence, the impact-related postoperative complications and the risk factors of vocal cord dysfunction (VCD) after left lung resection for cancer. Methods: From February 1996 to April 1999, a review of prospectively gathered data was performed on 99 consecutive patients who underwent a pneumonectomy ðn ¼ 50Þ or a lobectomy ðn ¼ 49Þ with a mediastinal lymph

  16. Female Sexual Dysfunction: Therapeutic Options and Experimental Challenges

    PubMed Central

    Allahdadi, Kyan J.; Tostes, Rita C.A.; Webb, R. Clinton

    2010-01-01

    Female sexual dysfunction (FSD) is a prevalent problem, afflicting approximately 40% of women and there are few treatment options. FSD is more typical as women age and is a progressive and widespread condition. Common symptoms associated with FSD include diminished vaginal lubrication, pain and discomfort upon intercourse, decreased sense of arousal and difficulty in achieving orgasm. Only a small percentage of women seek medical attention. In comparison to the overwhelming research and treatment for erectile dysfunction in males, specifically with the development of phosphodiesterase type 5 inhibitors, significantly less has been explored regarding FSD and treatment is primarily limited to psychological therapy. Several cardiovascular diseases have been linked with FSD including atherosclerosis, peripheral arterial disease and hypertension, all of which are also pathological conditions associated with aging and erectile dysfunction in men. Using animal models, we have expanded our understanding of FSD, however a tremendous amount is still to be learned in order to properly treat women suffering from FSD. The aim of this review is to provide the most current knowledge on FSD, advances in basic science addressing this dysfunction, and explore developing therapeutic options. PMID:19538161

  17. Identifying and Extinguishing Dysfunctional and Deadly Organizational Practices

    ERIC Educational Resources Information Center

    Mawhinney, Thomas C.

    2009-01-01

    It is possible to define an organization's culture in terms of its dominant behavioral practices and their molar consequences, from the shop floor to the executive suite (Redmon & Mason, 2001). Dysfunctional and potentially deadly practices (for the organization as a whole) can be "latent." They often go undetected until their dramatic…

  18. Probucol Protects against Hypochlorite-induced Endothelial Dysfunction

    Microsoft Academic Search

    Paul K. Witting; Ben J. Wu; Mark Raftery; Peter Southwell-Keely; Roland Stocker

    2005-01-01

    Atherosclerosis is associated with endothelial dysfunc- tion and a heightened state of inflammation characterized, in part, by an increase in vascular myeloperoxidase and proteins modified by its principal oxidant, hypochlorous acid (HOCl). Here we examined whether probucol could protect against endothelial dysfunction induced by the two-electron oxidant HOCl. Hypochlorous acid eliminated endothelium-dependent relaxation of rabbit aorta, whereas endothelial function and

  19. Voiding Dysfunction in Women with Lumbar Disc Prolapse

    Microsoft Academic Search

    H. B. Goldman; R. A. Appell

    1999-01-01

    :   A significant proportion of women with lumbar disc prolapse experience voiding dysfunction. The most common finding is detrusor\\u000a areflexia, frequently associated with impaired sensation. The pertinent neuropathophysiologic findings, clinical features\\u000a and methods of evaluation and treatment are reviewed.

  20. Female pelvic floor dysfunction—an imaging perspective

    Microsoft Academic Search

    Hans Peter Dietz

    2011-01-01

    Female pelvic floor dysfunction encompasses a range of morbidities, including urinary incontinence, female pelvic organ prolapse, anal incontinence and obstructed defecation. Patients often present with symptoms covered by several specialties including gastroenterology, colorectal surgery, urology and gynecology. Imaging can therefore bring clinicians from multiple specialties together by revealing that we frequently deal with different aspects of one underlying problem or